TY - JOUR
T1 - Schwannomas of the sciatic nerve
T2 - A rare and neglected diagnosis. A review of the literature with two illustrative cases
AU - Telera, Stefano
AU - Raus, Laura
AU - Vietti, Veronica
AU - Pace, Andrea
AU - Villani, Veronica
AU - Galié, Edvina
AU - Freda, Nicola
AU - Carosi, Mariantonia
AU - Costantini, Maurizio
N1 - Funding Information:
We thank Mrs Marzia Piccoli and Mrs Maria Di Santo for their editorial assistance and Miss Federica Falcioni for the drawing. Further editorial assistance and English revision of the text was provided by Aashni Shah (Polistudium SRL, Milan, Italy) and was supported by internal funds.
Publisher Copyright:
© 2020 Elsevier B.V.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/8
Y1 - 2020/8
N2 - Objective: Schwannomas of the sciatic nerve, which is the largest nerve of the human body, are very rare accounting for ≤ 1% of all schwannomas. They often may raise confusion with other more common causes of sciatica, such as lumbar degenerative and inflammatory diseases or spinal tumors, which may often lead to a late correct diagnosis. Patients and methods: We present two cases of sciatic nerve schwannomas that were recently treated at our Institution, and we review the pertinent English literature on this topic over the last 15 years, yielding twenty three cases to analyze. Results: Even if sciatic nerve schwannomas are a rare occurrence, a thorough clinical and radiological evaluation of the sciatic nerve should be considered whenever a sciatic pain is not otherwise explained. A positive Tinel sign and a palpable mass along the course of the sciatic nerve may be strong clues to achieve the diagnosis. Combined morphological and advanced functional MRI imaging may help to differentiate benign from malignant peripheral nerve sheath tumors, avoiding unnecessary preoperative biopsy. Conclusions: A standard microsurgical technique guided by ultrasound and neurophysiologic monitoring, allows in most of the cases a safe removal of the tumor and very satisfactory post-operative results for the patients.
AB - Objective: Schwannomas of the sciatic nerve, which is the largest nerve of the human body, are very rare accounting for ≤ 1% of all schwannomas. They often may raise confusion with other more common causes of sciatica, such as lumbar degenerative and inflammatory diseases or spinal tumors, which may often lead to a late correct diagnosis. Patients and methods: We present two cases of sciatic nerve schwannomas that were recently treated at our Institution, and we review the pertinent English literature on this topic over the last 15 years, yielding twenty three cases to analyze. Results: Even if sciatic nerve schwannomas are a rare occurrence, a thorough clinical and radiological evaluation of the sciatic nerve should be considered whenever a sciatic pain is not otherwise explained. A positive Tinel sign and a palpable mass along the course of the sciatic nerve may be strong clues to achieve the diagnosis. Combined morphological and advanced functional MRI imaging may help to differentiate benign from malignant peripheral nerve sheath tumors, avoiding unnecessary preoperative biopsy. Conclusions: A standard microsurgical technique guided by ultrasound and neurophysiologic monitoring, allows in most of the cases a safe removal of the tumor and very satisfactory post-operative results for the patients.
KW - Microsurgery
KW - Non-discogenic Sciatica
KW - Schwannoma
KW - Sciatic nerve
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U2 - 10.1016/j.clineuro.2020.105889
DO - 10.1016/j.clineuro.2020.105889
M3 - Article
C2 - 32422470
AN - SCOPUS:85084526653
VL - 195
JO - Clinical Neurology and Neurosurgery
JF - Clinical Neurology and Neurosurgery
SN - 0303-8467
M1 - 105889
ER -