Curious case of a median nerve cystic schwannoma in antecubital fossa: Case report

Abstract

Schwannomas are benign tumourarising from nerve sheath of peripheral nerves. Over prolonged time period these schwannomas may undergo cystic and degenerative changes showing nuclear pleomorphism. Due to their cystic appearance, they may be confused with other benign cystic lesions of peripheral nerves or malignant neoplasms and result in extensive excision of the nerve causing unnecessary functional impairment to the patient. Median nerve is not very commonly affected. Here we present anunusual case of a median nerve cystic schwannoma in the antecubital fossa which presented as a swelling along with paraesthesia along median nerve distribution. On exploration it was found to be eccentric tumour and was resected with preservation of the nerve. Hence, careful clinicalanalysis and radiological examination is important to avoid extensive nerve excision and functional impairment.Also to prevent post op complications since it’s a tumour involving the nerve sheath and when it is present in the antecubital fossa it’s in close proximation to the brachial artery and thus unnecessary surgical intervention can cause vascular injury.