A rare form of schwannomatosis on the volar surface of the hand and wrist: A case report

Background

Schwannomas, which are also known as neurilemomas, constitute the most common type of peripheral nerve tumors. These tumors can grow slowly and occur as painless swellings over the course of several years before their diagnosis. The aim of this report is to present a case of a very rare plexiform schwannoma originating from second digital nerve and multiple schwannomas from third and fourth digital nerves and palmar cutaneous branch of median nerve with emphasis given on differential diagnosis and treatment strategy.

Case Presentation

A 15-year-old patient presented with soft tissue masses on the volar surface of the hand, initially diagnosed as benign nerve sheath tumors. Surgical excision was performed twice, preserving nerves and tendons. Recurrence occurred, and subsequent biopsy confirmed benign nerve sheath tumors. Microscopic examination revealed multinodular/plexiform schwannoma in the larger lesion and simple schwannomas in others, leading to a diagnosis of multiple schwannomatosis. All surgeries resulted in intact sensory and motor function.

Conclusion

Surgical treatment can be curative and effectively employed for concomitant schwannoma tumors. Nevertheless, with careful planning and execution, surgery remains a promising option for patients with concomitant schwannomas. Further research and long-term follow-up studies are needed to fully understand the outcomes and refine the techniques used in these surgical treatments.