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Neurology

Schwannoma (Neurilemmoma), Extremity Nerve

ICD-10 Code
D36.1

Benign, slow-growing tumor arising from the Schwann cells of a peripheral nerve sheath.

Clinical Presentation & Protocol

Patient Usually Complains Of

Patient presents with a palpable, slow-growing, non-tender subcutaneous mass in the [Location, e.g., volar aspect of the forearm]. Reports occasional paresthesia or radiating "electric" sensation upon direct palpation (Tinel-like sign). Denies rapid enlargement, constitutional symptoms, or significant motor deficit.

Clinical Examination Findings

Physical exam reveals a firm, well-circumscribed, mobile mass perpendicular to the long axis of the nerve, but restricted mobility parallel to the nerve. Tinelโ€™s sign is positive over the lesion. No overlying skin changes, ulceration, or neurovascular compromise distal to the mass. Strength and sensation are intact in the affected nerve distribution.

Treatment Protocol

Surgical excision via microsurgical dissection is recommended. The tumor is typically encapsulated and can be enucleated from the parent nerve with preservation of nerve fascicles. Intraoperative nerve monitoring is advised. Post-operative management includes wound care, immobilization if necessary, and gradual return to activity.

Detailed clinical guide coming soon.