PMC7755489_01
MRI axial showing right sciatic nerve tumor, 4 cm from the skin.
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An MRI of the right thigh showed a tumor along the right sciatic nerve, 3 cm in size (Figure 1).
(a) Intraoperative ultrasound localizing tumor. (b) Planned incision along the right posterior thigh.
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During the procedure, the patient was placed prone, and an intraoperative ultrasound confirmed that the tumor was 18 cm from the popliteal fossa (Figure 2).
Gross specimen of schwannoma.
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A section of tumor was sent for pathology, and the tumor was histologically confirmed to be a schwannoma (Figures 3 and 4).
(a) H&E high magnification (X200) of Antoni A area with Verocay bodies formation. (b) H&E low magnification (X40) of biphasic spindle cell lesion with cellular Antoni A areas and numerous Verocay bodies formation on the right, along with many hyalinized vessels and fresh hemorrhage, characteristic of schwannoma. Hypocellular area with looser stroma or Antoni B pattern is on the left. Pigment laden macrophages are present around vessels at the bottom of the image, representing evidence of old microbleed.
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A section of tumor was sent for pathology, and the tumor was histologically confirmed to be a schwannoma (Figures 3 and 4).
(a) View of the surgical field with tumor along the sciatic nerve. (b) Tumor excised with sciatic nerve left intact (yellow arrow).
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Debulking was avascular, and the tumor was excised from the nerve, with minimal fascicle loss (Figure 5).