MULTIPLE BRACHIAL PLEXUS SCHWANNOMAS - A RARE CASE

Background: Schwannoma is a benign encapsulated nerve sheath tumour that arises from the Schwann cells along the course of a nerve and can affect the third to 12th cranial nerves, peripheral and autonomic nerves. Schwannoma was first described by Verocay in 1908. Schwannoma rarely affects brachial plexus, accounting for 5% of all cases of schwannoma.

Case: 38year old female patient presented with a left axillary mass noticed since 1 year. The mass was slowly increasing in size and was painful associated with tingling and numbness over medial aspect of left arm, forearm and hand. MRI was Suggestive of multiple, well defined, round to oval altered signal intensity lesions noted in infraclavicular region of axilla and upper arm on left side along the course of neurovascular bundles. On exploration left brachial plexus through left axillary approach , total of 11 nerve sheath tumours noted and dissected from territory of medial brachial cutaneous nerve and intercostobrachial nerve of the left arm. Histopathology report was suggestive of left axillary schwannoma with no evidence of malignancy.

Conclusion: SchwannomaÂ’s around neck and axilla region are uncommon lesions arising from peripheral nerves and should be considered as one of the differential while evaluation.