Abstract:Epithelioid hemangioendothelioma (EH) is a rare vascular malignant sarcoma. To date, there are only two published case reports of EH mimicking nerve sheath tumors of a peripheral nerve. A 41-year-old woman presented with a painful node on the inside of the upper arm and motor deficits of the ulnar nerve. Magnetic resonance imaging (MRI) follow-up and neurosonography revealed a slowly progressive, contrast-enhancing tumor in the area of the neurovascular bundle. A schwannoma of the ulnar nerve was suspected. At… Show more
“…45 These tumors when they arise from neurovascular bundle may mimic neurogenic tumors like Schwannoma which is more common than these vascular tumors. 47,48 Neoplasms Ganglion cyst. Ganglion cysts are benign cystic masses that most commonly occur at the wrist.…”
Section: Metabolicmentioning
confidence: 99%
“…45 These tumors when they arise from neurovascular bundle may mimic neurogenic tumors like Schwannoma which is more common than these vascular tumors. 47,48 Figure 6.(a) Color Doppler ultrasound just above the wrist showing a well-circumscribed hypoechoic soft tissue mass arising from the wall of ulnar artery (white arrow) with mild compression on vascular lumen and abutting the ulnar nerve (black arrow). (b) Axial T1-weighted image shows the eccentric mass arising from wall of the ulnar artery (black arrow) and thickened ulnar nerve (white arrow) due to tumor infiltration.…”
The ulnar nerve is the second most commonly entrapped nerve after the median nerve. Although clinical evaluation and electrodiagnostic studies remain widely used for the evaluation of ulnar neuropathy, advancements in imaging have led to increased utilization of these newer / better imaging techniques in the overall management of ulnar neuropathy. Specifically, high-resolution ultrasonography of peripheral nerves as well as MRI has become quite useful in evaluating the ulnar nerve in order to better guide treatment. The caliber and fascicular pattern identified in the normal ulnar nerves are important distinguishing features from ulnar nerve pathology. The cubital tunnel within the elbow and Guyon’s canal within the wrist are important sites to evaluate with respect to ulnar nerve compression. Both acute and chronic conditions resulting in deformity, trauma as well as inflammatory conditions may predispose certain patients to ulnar neuropathy. Granulomatous diseases as well as both neurogenic and non-neurogenic tumors can also potentially result in ulnar neuropathy. Tumors around the ulnar nerve can also lead to mass effect on the nerve, particularly in tight spaces like the aforementioned canals. Although high-resolution ultrasonography is a useful modality initially, particularly as it can be helpful for dynamic evaluation, MRI remains most reliable due to its higher resolution. Newer imaging techniques like sonoelastography and microneurography, as well as nerve-specific contrast agents, are currently being investigated for their usefulness and are not routinely being used currently.
“…45 These tumors when they arise from neurovascular bundle may mimic neurogenic tumors like Schwannoma which is more common than these vascular tumors. 47,48 Neoplasms Ganglion cyst. Ganglion cysts are benign cystic masses that most commonly occur at the wrist.…”
Section: Metabolicmentioning
confidence: 99%
“…45 These tumors when they arise from neurovascular bundle may mimic neurogenic tumors like Schwannoma which is more common than these vascular tumors. 47,48 Figure 6.(a) Color Doppler ultrasound just above the wrist showing a well-circumscribed hypoechoic soft tissue mass arising from the wall of ulnar artery (white arrow) with mild compression on vascular lumen and abutting the ulnar nerve (black arrow). (b) Axial T1-weighted image shows the eccentric mass arising from wall of the ulnar artery (black arrow) and thickened ulnar nerve (white arrow) due to tumor infiltration.…”
The ulnar nerve is the second most commonly entrapped nerve after the median nerve. Although clinical evaluation and electrodiagnostic studies remain widely used for the evaluation of ulnar neuropathy, advancements in imaging have led to increased utilization of these newer / better imaging techniques in the overall management of ulnar neuropathy. Specifically, high-resolution ultrasonography of peripheral nerves as well as MRI has become quite useful in evaluating the ulnar nerve in order to better guide treatment. The caliber and fascicular pattern identified in the normal ulnar nerves are important distinguishing features from ulnar nerve pathology. The cubital tunnel within the elbow and Guyon’s canal within the wrist are important sites to evaluate with respect to ulnar nerve compression. Both acute and chronic conditions resulting in deformity, trauma as well as inflammatory conditions may predispose certain patients to ulnar neuropathy. Granulomatous diseases as well as both neurogenic and non-neurogenic tumors can also potentially result in ulnar neuropathy. Tumors around the ulnar nerve can also lead to mass effect on the nerve, particularly in tight spaces like the aforementioned canals. Although high-resolution ultrasonography is a useful modality initially, particularly as it can be helpful for dynamic evaluation, MRI remains most reliable due to its higher resolution. Newer imaging techniques like sonoelastography and microneurography, as well as nerve-specific contrast agents, are currently being investigated for their usefulness and are not routinely being used currently.
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