Recurrent Schwannoma With Bony Erosion of the Distal Middle Finger: A Case Report
Addison G. Wilson, Jr., MD, Eric P. Hofmeister, MD, and Michael Thompson, MD
Dr. Wilson is Physician, Undersea Medical Officer School, Groton, Connecticut.
Dr. Hofmeister is Director, Hand and Microvascular Division, Orthopaedic Surgery Department, Naval Medical Center San Diego, and Assistant Professor of Surgery, Uniformed Services University of the Health Sciences, San Diego, California.
Dr. Thompson is Program Director, Orthopaedic Department, Naval Medical Center San Diego, San Diego, California.
Abstract not available. Introduction provided instead.
Schwannomas, also known as neurilemomas, are a benign peripheral nerve sheath tumor composed of well-differentiated Schwann cells. Although they may be difficult to diagnose prior to surgery, schwannomas are distinguished intraoperatively as round, well-encapsulated eccentric tumors that are easily separated from local peripheral nerves.1-3 Although schwannomas are often associated with neurofibromatosis type 2, most occur sporadically.4-5 Treatment usually is simple mass excision while taking care to spare the contributory nerve.3-4 Recurrence after excision is rare,3,6,7 as is erosion of the adjacent bone.8-10 We present an unusual case of a schwannoma involving a digital nerve that not only had recurred multiple times but also had uncharacteristic bony erosion and nail bed destruction, which required bone grafting and nail bed reconstruction.