Schwannoma of the ulnar nerve: Excision from forearm
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Peripheral nerve sheath tumours are rare but the true incidence is unknown as many are asymptomatic and present as spurious findings on imaging for other pathologies. When they are large or occur at natural compression points they are more likely to be symptomatic. Small subcutaneous nerve sheath tumours may present as small lumps that are painful if touched. Most tumours fall into the benign category and are either Schwannoma or Neurofibroma subtypes. Most are solitary but both can present as multiple tumours in neurofibromatosis. Multiple Schwannomas are also a feature of a separate genetic condition Schwannomatosis in which strings of multiple tumours may arise from a single nerve trunk.
Small asymptomatic tumours with no adverse features on clinical examination or imaging may be clinically monitored with repeat imaging only if there is a change in size or symptom profile.
Author: Mr Dominic Power FRCS (Tr & Orth)
Institution: The Queen Elizabeth Hospital ,Birmingham ,UK.
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