Sciatic schwannoma: rare case report

Abstract

Introduction: Schwannoma is the most common benign tumor of the peripheral nerve sheath. They appear in the sheath of the nervous fascicle and are well-defined masses, which allow their dissection of the underlying neural bundle. Sciatic nerve involvement is rare, accounting for less than 1%. Case report: Male, 83. He has had sciatica on the left for 10 months. With progression of pain, VAS of 9 and difficulty to walk for 1 month after admission. On physical examination, a positive tinel sign in the left gluteal region with tactile perception of nodular lesion in sciatic nerve topography. Preserved and discrete hypoesthesia strength in left sciatic nerve territory. MRI shows nodular lesion, suggestive of neural sheath tumor. Undergoing a surgical procedure for excision of the lesion. Total resection of the lesion was performed with no changes in monitoring potential. The patient was discharged from the hospital the next day, with a VAS of 0, with no other complaints and pain control. Discussion: Schwannomas have a long subclinical course, their clinical presentation is usually misleading. The referred patient started with sciatica, with painful progression to VAS 9. The diagnoses of sciatic nerve schwannomas are made with MRI. The definitive diagnosis is possible after the histopathological study. The treatment of this tumor is by massive excision and preservation of the nerve. Conclusion: Studies regarding sciatic nerve Schwannoma are scarce. There is a need for further studies on the case, to train health professionals to recognize and effectively treat the pathology.