1/60. Intraneural synovial sarcoma of the median nerve.Intraneural synovial sarcomas are extremely rare in the main nerve trunks of the upper limb. We report on a 16-year-old youth who presented with a painless mass on the flexor aspect of the wrist with the clinical appearance of a ganglion. At operation there was a tumour of the median nerve that was shown on histology to be an intraneural synovial sarcoma.- - - - - - - - - - ranking = 1keywords = median nerve, median (Clic here for more details about this article) |
2/60. Intraneural perineurioma involving the median nerve.Intraneural perineurioma is a rare clinical entity, which tends to affect major nerve trunks in the upper extremities. On light microscopy, numerous pseudo-onion-bulb structures having a central clear area are surrounded by concentric layers of eosinophilic elongate cells having spindled nuclei. immunohistochemistry of concentric cells stains positive for epithelial membrane antigen but negative for S100 protein. Because of the small number of cases, no consensus has been made on proper treatment of this entity. Although none of the patients who have had excision of tumor with nerve grafting have had sensory nerve recovery, we believe each patient should be individualized until more data are available regarding this tumor.- - - - - - - - - - ranking = 0.8keywords = median nerve, median (Clic here for more details about this article) |
3/60. Fibrolipoma of the median nerve: a case report and review of the literature.A 38 year-old patient presented with right median nerve distribution paresthesias. Electrodiagnostic studies confirmed severe carpal tunnel syndrome. A palmar mass prompted a magnetic resonance imaging scan, which suggested a fibrolipoma of the median nerve. Carpal tunnel release resulted in resolution of preoperative pain and paresthesias. We review the literature dealing with this primary nerve tumor.- - - - - - - - - - ranking = 1.2keywords = median nerve, median (Clic here for more details about this article) |
4/60. An unusual schwannoma of the median nerve: effects on the motor branch.An unusual case of a schwannoma of the median nerve is presented where pressure due to the tumour on the motor branch to the thenar muscles caused weakness and wasting of the abductor pollicis brevis muscle, a previously unreported phenomenon. The patient achieved a full functional recovery after enucleation, which is also unusual considering the patient's age. Aspects of schwannoma biology, differential diagnosis, investigation and treatment are discussed.- - - - - - - - - - ranking = 1keywords = median nerve, median (Clic here for more details about this article) |
5/60. Pacinian corpuscle neuroma of digital nerves.Symptoms and incapacitation due to abnormal aggregations of pacinian corpuscles are uncommon. Indeed, only three reports have been found in the scientific literature. A case is presented in which the patient's chief complaint was pain and localized tenderness in the hand which interfered with normal activity. Surgical exploration of the palm showed abnormalities of pacinian corpuscles attached to the median digital nerve in the form of a grape-like cluster and a single enlarged corpuscle beneath the epineurium; the abnormality attached to the ulnar digital nerve appeared as an offshoot of hyperplastic corpuscles lying in tandem. The abnormal corpuscles were excised. The symptoms have not recurred to date. These abnormalities in size, position, and number of pacinian corpuscles are compared to the findings of the few other reports in the literature. The neuroma formation found attached to this ulnar nerve has not been cited previously.- - - - - - - - - - ranking = 0.0010183762794048keywords = median (Clic here for more details about this article) |
6/60. Neurilemmona of the median nerve in a child. Case report.A case of neurilemmoma of the median nerve in a child is reported. The rarity, the contribution to the diagnosis of the newer imaging methods, especially MRI, as well as the good prognosis after a careful enucleation of the tumor, are emphasized.- - - - - - - - - - ranking = 1keywords = median nerve, median (Clic here for more details about this article) |
7/60. Postoperative edema after vascular access causing nerve compression secondary to the presence of a perineuronal lipoma: case report.OBJECTIVE AND IMPORTANCE: median nerve neuropathy can be clinically devastating to a patient. It can be caused by compression of the median nerve anywhere along its course. We present the case of delayed median nerve neuropathy after the placement of a vascular graft in the arm. CLINICAL PRESENTATION: An arm shunt was placed in the nondominant upper extremity in a 60-year-old man with end-stage renal disease. Twelve hours postoperatively, the patient developed neurapraxia in the median nerve distribution in the hand. INTERVENTION: Exploration of the arm revealed a lipoma coursing along and deep to the median nerve. Resection of the lipoma decompressed the nerve. CONCLUSION: In this patient, median nerve neuropathy was caused by a lipoma and postoperative swelling from placement of the vascular graft. The swelling that occurred after the shunt placement unmasked subclinical compression of the nerve by a lipoma deep to the median nerve. To our knowledge, this report is unique in documenting damage to the median nerve after vascular graft placement as a result of an occult mass.- - - - - - - - - - ranking = 1.4keywords = median nerve, median (Clic here for more details about this article) |
8/60. neurofibroma in the median nerve treated with resection and free nerve transplantation. case reports.The commonest tumours of the peripheral nerves are neurolemomas and neurofibromas, both arising from the nerve sheath. Both tumour types are described. It is established that the neurofibroma becomes malignant in about 10% of cases and that removal involves resection of the nerve. Radical resection is nevertheless recommended and the defect in the nerve may be overcome by free nerve transplantation. Two cases are reported.- - - - - - - - - - ranking = 0.8keywords = median nerve, median (Clic here for more details about this article) |
9/60. Multiple neurilemmomas of the median and ulnar nerves with a communicating branch in the same upper extremity.A 30-year-old woman presented with multiple neurilemmomas in the same upper extremity. One originated from the main trunk of the ulnar nerve and two others from the sensory branch of the median nerve. A communicating branch in the palm from the ulnar nerve to the median nerve was confirmed. All the tumours were successfully enucleated and she made a satisfactory recovery.- - - - - - - - - - ranking = 0.40407350511762keywords = median nerve, median (Clic here for more details about this article) |
10/60. The role of supraorbital nerve biopsy in cutaneous malignancies of the periocular region.PURPOSE: To describe clinical situations in which a biopsy or resection of the supraorbital nerve may play a role in patients in whom perineural invasion secondary to cutaneous head and neck malignancies is suspected. methods: The clinical records of 230 patients with squamous cell carcinoma (SCCA) of the skin of the head and neck who were treated at the University of texas M.D. Anderson Cancer Center between April 1994 and March 2001 were reviewed. Thirty-five patients were identified as having primary lesions on the forehead skin. Of these, 8 patients had microscopic or clinical evidence of perineural invasion. Four of these 8 patients had undergone a supraorbital nerve biopsy or resection in the course of their treatment. Although all 4 patients were classified as having had SCCA, 1 patient had a variant of undifferentiated SCCA that more appropriately should have been classified as lymphoepithelioma-like carcinoma. The clinical history was reviewed in each case. The median follow-up time for this cohort was 47 months (range, 24 to 72 months). RESULTS: The 4 cases reported here illustrate that a supraorbital nerve biopsy can help confirm the diagnosis of perineural invasion, identify the extent of tumor infiltration, and help in staging of particularly aggressive cutaneous malignancies of the periocular region. Access to the proximal (orbital) portion of the nerve can be accomplished through an anterior orbitotomy. CONCLUSIONS: A biopsy of the peripheral branches of the trigeminal nerve may be indicated as part of the staging or to confirm the diagnosis of perineural invasion in patients with SCCA or other locally aggressive cutaneous malignancies of the head and neck.- - - - - - - - - - ranking = 0.0010183762794048keywords = median (Clic here for more details about this article) |
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