Brachial Plexus Middle Trunk Schwannoma: A Case Report with Uncommon Localization and Literature Review
N. Irawati *
Department of Surgery, Head and Neck Surgery Unit, Dr. Soetomo General Hospital, Surabaya, Indonesia
R. Walukow
Department of Surgery, Head and Neck Surgery Unit, Dr. Soetomo General Hospital, Surabaya, Indonesia
D. Hari Susilo
Department of Surgery, Head and Neck Surgery Unit, Dr. Soetomo General Hospital, Surabaya, Indonesia
E. H. Kusumastuti
Department of Pathology, Dr. Soetomo General Hospital, Surabaya, Indonesia
S. Reksoprawiro
Department of Surgery, Head and Neck Surgery Unit, Dr. Soetomo General Hospital, Surabaya, Indonesia
*Author to whom correspondence should be addressed.
Abstract
Aim: We report a case of schwannoma arising from the middle trunk of the right brachial plexus and presented with radiating pain down to lower arm. The patient developed temporary neurological deficit after surgery.
Presentation of Case: A 30- year old patient presented with history of lump on right lower neck in last nine months. The patient did not have a significant complaint, but occasionally felt sharp pain which was radiating down to right lower arm. USG of the neck showed a hypoechoic soft tissue mass with posterior acoustic enhancement and FNAC suggested of schwannoma.
Discussion and Conclusion: This case report indicates uncommon location of schwannoma in the neck related to symptoms that may occur as the mass increases in size. In our case, we report a case with involvement of the middle trunk of the brachial plexus, which is relatively rare for schwannoma to appear. Surgical excision is the treatment of choice, with recurrence being rare. Excision of the tumor without injuring the parent nerve demands detailed preoperative planning and meticulous dissection. This case highlights the importance of understanding anatomy of surrounding structures to prevent serious complications post operatively.
Keywords: Brachial plexus tumors, middle trunk, Schwannoma