Schwannomatosis del nervio plantar interno.

Presentación de caso. Premio Póster. XV Jornadas de Neurocirugía 2019

Abstract

Introduction: Mononeural Schwannomatosis located at limbs are very infrequent entities, the knowledge about its are very poor, and there are just a few publications related to them. This articles make reference multiple nodular or plexiform lesions with involvement oh only one nerve, every one whit diagnosis of schwannoma, excluding fibromatosis. In this article, we describe a patient with who suffered the involvement of multiples tumours with nodular and plexiform configuration.
Material y method: The clinical case was analysed by different media, clinical, neuro physiological and by neuroimages. By this approaches were defined and evaluated the surgical outcomes and results.
Clinical case: Male, 45 years old. Multiples tumours at plantar region. Tinel Sign with multiple palpable masses al retromaleolar sulcus and plantar region, plantar schwannoma operated on previously.
RMN: multinodular configuration at level of medial plantar nerve, with intermediate contrast reinforcement.
An extended approach was performed, from retromaleolar sulcus to medial aspect of the foot, and finishing inside the digital-plantar sulcus. Complete resection was performed, multiples nodulos were found, the bigger had a plexiform configuration, was imposible the preservation of the nerve trunk and the, the interposition of sural nerve was realized. With good evolution
Conclusions: For this very rare entities, the bigger frequency was reported et limbs.
The most frequent locations was at medial nerve, second place occupied by the ulnar nerve, we didn’t find on international literature a plexiform tumour inside the medial plantar nerve.
On the other hand, we think that the complete resection for this tumours when are nodular, the complete resection with preservation of the main trunk, is feasible. Ehen the tumour has a plexiform pattern; complete resection is only feasible with trunk nerve resection and interposition of nerve graft.