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Intramuscular ancient schwannoma of the axillary nerve
  1. Vishali Moond1,
  2. Preeti Diwaker2,
  3. Reshma Golamari3 and
  4. Rohit Jain3
  1. 1Medicine, University College of Medical Sciences, Delhi, Delhi, India
  2. 2Department of Pathology, University College of Medical Sciences, Delhi, Delhi, India
  3. 3Department of Internal Medicine, Penn State Health Milton S Hershey Medical Center, Hershey, Pennsylvania, USA
  1. Correspondence to Dr Rohit Jain; rjain{at}pennstatehealth.psu.edu

Abstract

We present the case of an adolescent with an intramuscular ancient schwannoma of the axillary nerve which, to the best of our knowledge, has not been reported before. Due to its deep location, intramuscular schwannoma has less clinical signs and hence, is difficult to diagnose. Ancient schwannoma, characterised by degeneration due to long course, is rare and can be mistaken for malignancy due to heterogeneous intensity and degeneration evident on MRI and nuclear atypia on histopathology. It is important to differentiate it from malignancy based on a clinically benign swelling with a long history, well-encapsulated mass on MRI with the split fat sign and absence of significant mitotic activity despite nuclear atypia. The aim of surgery should be enucleation of the tumour while preserving the function of the parent nerve.

  • neuromuscular disease
  • neurooncology
  • head and neck cancer
  • pathology
  • surgical oncology

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Footnotes

  • Contributors VM: contributed to the write up of the article. PD: provided all the pathological inputs related to the article. RG: revised the article to provide critical content. RJ: helped to provide article accuracy and integrity to come up with the final version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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