Abstract

CORTES, S. et al. Brachial plexus schwannoma. Rev. Soc. Esp. Dolor [online]. 2006, vol.13, n.8, pp.538-541. ISSN 1134-8046.

Schwannomas are tumors origined from Schwann cells, unfrequent, and generally benign. Pain and radiculopathy are common initial symptoms. Diagnosis is based in magnetic resonance imaging (MRI) and surgery is the election treatment. We describe the case of a 50 years old woman, with a five years long left atraumatic omalgia. During this time, she was evaluated by different physicians such as traumatologist, neurologist, rheumatologist and rehabilitation doctor. Initially she was treated with NSAID, rehabilitation (physiotherapy, short wave and magnetotherapy) without improvement. Diagnostic procedures underwent were neurophysiologic study of left upper-extremity, wich was normal; cervical and shoulder MRI with partial tear of supraspinatus tendon and subacromial bursitis; the patient underwent an arthroscopic subacromial decompression. This treatment did not relieve the pain of the patient with an AVS > 6 at that moment. Subsequently she was treated with NSAID associated to transdermic fentanyl, pregabalin, join steroid injections and new sessions of rehabilitation without improvement. It was decided to make more imaging procedures to find a clear aetiology for upper-extremity pain. A thoracic scanner, a left shoulder ecography and a brachial plexus MRI were made and showed a lesion that was compatible with a brachial plexus schwannoma. After surgical treatment and tumor excision the patient had a progressive pain relief. At this time the patient has no pain nor any neurological damage.

Keywords : schwannoma of brachial plexus; neurinoma; painful shoulder.

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