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Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature

Melanotic schwannoma is a rare tumor with indeterminate biologic behavior and varying treatment recommendations. Just about 200 cases have been reported worldwide, in which occurred in peripheral nerves has even less reported. Due to the lack of cognition of melanotic schwannoma, it is easy to be mi...

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Autores principales: Wang, Han, Shi, Lin, Tian, Tong, Xian, Hang, Song, Zhao, Cong, Rui, Zhao, Rui
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909008/
https://www.ncbi.nlm.nih.gov/pubmed/36779049
http://dx.doi.org/10.3389/fneur.2023.1103604
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author Wang, Han
Shi, Lin
Tian, Tong
Xian, Hang
Song, Zhao
Cong, Rui
Zhao, Rui
author_facet Wang, Han
Shi, Lin
Tian, Tong
Xian, Hang
Song, Zhao
Cong, Rui
Zhao, Rui
author_sort Wang, Han
collection PubMed
description Melanotic schwannoma is a rare tumor with indeterminate biologic behavior and varying treatment recommendations. Just about 200 cases have been reported worldwide, in which occurred in peripheral nerves has even less reported. Due to the lack of cognition of melanotic schwannoma, it is easy to be misdiagnosed and mistreatment in primary hospitals. Herein, we presented a case of massive melanotic schwannoma growing in the brachial plexus of an elderly male patient. First, the patient underwent a left forearm tumor resection in the local primary hospital because a painless lump was found there in 2017, of which details remain unclear. After this operation, the patient developed the symptoms of left median nerve injury. Thus, he came to our hospital and underwent a second operation. During this operation, we found that a part of the median nerve was absent at the left forearm, and the remanent median nerve, from the broken end to the elbow, was totally turned black, which was accompanied by petroleum-like exudate. Losing the opportunity for nerve repair, the black nerve was removed extensively and thoroughly. Postoperative pathological diagnosis revealed that the tumor was melanotic schwannoma. Then 4 years later, the tumor recurrence again, which led to the paralysis of the whole left arm and severe nerve pain, and the pulmonary metastasis of the tumor was detected at the same time. The black nerve was resected again in our hospital, and the nerve pain was partially relieved after the operation. To the best of our knowledge, it is the first time to report a melanotic schwannoma case that happened in the peripheral nerve trunk and then spread to the whole brachial plexus. There were many questions that worthy of discussion could be invited from this case, and we analyzed and discussed them based on the relevant literature. In conclusion, we reported a rare case of melanotic schwannoma that happened in the brachial plexus and illustrated the problems of the diagnosis and treatment of it based on the analysis of the relevant literature, which is helpful for the cognition of this rare nerve tumor.
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spelling pubmed-99090082023-02-10 Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature Wang, Han Shi, Lin Tian, Tong Xian, Hang Song, Zhao Cong, Rui Zhao, Rui Front Neurol Neurology Melanotic schwannoma is a rare tumor with indeterminate biologic behavior and varying treatment recommendations. Just about 200 cases have been reported worldwide, in which occurred in peripheral nerves has even less reported. Due to the lack of cognition of melanotic schwannoma, it is easy to be misdiagnosed and mistreatment in primary hospitals. Herein, we presented a case of massive melanotic schwannoma growing in the brachial plexus of an elderly male patient. First, the patient underwent a left forearm tumor resection in the local primary hospital because a painless lump was found there in 2017, of which details remain unclear. After this operation, the patient developed the symptoms of left median nerve injury. Thus, he came to our hospital and underwent a second operation. During this operation, we found that a part of the median nerve was absent at the left forearm, and the remanent median nerve, from the broken end to the elbow, was totally turned black, which was accompanied by petroleum-like exudate. Losing the opportunity for nerve repair, the black nerve was removed extensively and thoroughly. Postoperative pathological diagnosis revealed that the tumor was melanotic schwannoma. Then 4 years later, the tumor recurrence again, which led to the paralysis of the whole left arm and severe nerve pain, and the pulmonary metastasis of the tumor was detected at the same time. The black nerve was resected again in our hospital, and the nerve pain was partially relieved after the operation. To the best of our knowledge, it is the first time to report a melanotic schwannoma case that happened in the peripheral nerve trunk and then spread to the whole brachial plexus. There were many questions that worthy of discussion could be invited from this case, and we analyzed and discussed them based on the relevant literature. In conclusion, we reported a rare case of melanotic schwannoma that happened in the brachial plexus and illustrated the problems of the diagnosis and treatment of it based on the analysis of the relevant literature, which is helpful for the cognition of this rare nerve tumor. Frontiers Media S.A. 2023-01-26 /pmc/articles/PMC9909008/ /pubmed/36779049 http://dx.doi.org/10.3389/fneur.2023.1103604 Text en Copyright © 2023 Wang, Shi, Tian, Xian, Song, Cong and Zhao. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neurology
Wang, Han
Shi, Lin
Tian, Tong
Xian, Hang
Song, Zhao
Cong, Rui
Zhao, Rui
Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title_full Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title_fullStr Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title_full_unstemmed Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title_short Case report: A rare case of massive peripheral nerve melanotic schwannoma and review of the literature
title_sort case report: a rare case of massive peripheral nerve melanotic schwannoma and review of the literature
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9909008/
https://www.ncbi.nlm.nih.gov/pubmed/36779049
http://dx.doi.org/10.3389/fneur.2023.1103604
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