TY - JOUR
T1 - The effect of ozone injection within a common peroneal nerve schwannoma
T2 - A mistreatment due to a misdiagnosis
AU - Vetrano, Ignazio Gaspare
AU - Acerbi, Francesco
AU - Marucci, Gianluca
AU - Nazzi, Vittoria
N1 - Publisher Copyright:
© 2020 Published by Scientific Scholar on behalf of Surgical Neurology International
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/12/4
Y1 - 2020/12/4
N2 - Background: Peripheral schwannomas can be misdiagnosed or mistreated as they can mimic other subcutaneous lesions, leading to wrong diagnosis and, therefore, to improper treatment. Case Description: A 23-years-old male presented a painful growing nodule at the left popliteal fossa, with distally irradiated pain. A first magnetic resonance imaging depicted a heterogeneous lesion between common peroneal and sural nerves but, surprisingly, the patient was submitted to perilesional injection of ozone-oxygen mixture, causing the onset of intense neuropathic pain. A second MRI showed a morphological change of tumor characteristics. He finally underwent surgery but, intraoperatively, inter-fascicular fibrous adherences were noticed, making the tumor removal more difficult and riskier. The histopathological diagnosis was of schwannoma with areas of foreign body reaction. Conclusion: The injection of ozone or other substances within a subcutaneous swelling should be avoided, before a complete imaging assessment; because of such swelling could be a peripheral nerve schwannoma. The correct assessment of a lesion of the limbs determining radiating pain should be carefully demanded to a thorough history, clinical examination, and appropriate imaging technique. To avoid incorrect management, the treatment of such tumors should be performed in the first place by dedicated equips with proven expertise in this field.
AB - Background: Peripheral schwannomas can be misdiagnosed or mistreated as they can mimic other subcutaneous lesions, leading to wrong diagnosis and, therefore, to improper treatment. Case Description: A 23-years-old male presented a painful growing nodule at the left popliteal fossa, with distally irradiated pain. A first magnetic resonance imaging depicted a heterogeneous lesion between common peroneal and sural nerves but, surprisingly, the patient was submitted to perilesional injection of ozone-oxygen mixture, causing the onset of intense neuropathic pain. A second MRI showed a morphological change of tumor characteristics. He finally underwent surgery but, intraoperatively, inter-fascicular fibrous adherences were noticed, making the tumor removal more difficult and riskier. The histopathological diagnosis was of schwannoma with areas of foreign body reaction. Conclusion: The injection of ozone or other substances within a subcutaneous swelling should be avoided, before a complete imaging assessment; because of such swelling could be a peripheral nerve schwannoma. The correct assessment of a lesion of the limbs determining radiating pain should be carefully demanded to a thorough history, clinical examination, and appropriate imaging technique. To avoid incorrect management, the treatment of such tumors should be performed in the first place by dedicated equips with proven expertise in this field.
KW - Common peroneal nerve
KW - Foreign body reaction
KW - Nerve tumors
KW - Oxygen-ozone therapy
KW - Schwannoma
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U2 - 10.25259/SNI_296_2020
DO - 10.25259/SNI_296_2020
M3 - Article
AN - SCOPUS:85098144122
VL - 11
JO - Surgical Neurology International
JF - Surgical Neurology International
SN - 2152-7806
M1 - 413
ER -