Presentation
Left sciatic pain.
Patient Data
The lesion arising from the sciatic nerve at the level of the distal femoral shaft is unchanged in size, measuring 24 x 25 x 28 mm (AP, trans, CC). This signal characteristics are also unchanged, remaining heterogenous but predominantly high signal on T2, homogeneously low signal on T1, with intense contrast enhancement apart.
CONCLUSION:
Stable appearance of the sciatic nerve lesion with features in keeping with schwannoma.
Case Discussion
This case was confirmed as a sciatic schwannoma, a rare presentation of schwannoma. They are the most frequent peripheral nerve sheath tumors 1.
The main differential diagnosis is made with neurofibromas, which are usually multiple, lack tumor capsule, and cause fusiform enlargement of distal nerves.
The sciatic nerve arises from the sacral plexus from the roots of L4-S3 and runs through the buttock and down the lower limb. It is the longest and widest single nerve in the body.