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Das Schwannom des Nervus femoralis

Eine seltene Differenzialdiagnose bei Oberschenkelschmerzen

Schwannoma of the femoral nerve

A rare differential diagnosis of leg pain

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Zusammenfassung

Hintergrund

Schwannome (Neurinome) gehören zu den häufigsten peripheren Nerventumoren. Die Lokalisation im Bereich der unteren Extremitäten mit Assoziation zum N. femoralis ist jedoch eine Rarität.

Klinischer Fall

In diesem Fall wird das Auftreten eines Schwannoms in Assoziation zum N. femoralis beschrieben. Beim vorgestellten Patienten kam es zu unspezifischen Schmerzen im Bereich des Oberschenkels begleitet von einer tastbaren Raumforderung. Sensomotorische Defizite lagen nicht vor. Im Rahmen der erweiterten Diagnostik mittels MRT, Biopsie und anschließender Histopathologie konnte die Diagnose eines Schwannoms gestellt werden. Der Tumor wurde vollständig exstirpiert.

Schlussfolgerungen

Auch wenn Schwannome der unteren Extremitäten selten vorkommen, sollten sie in die differenzialdiagnostischen Überlegungen bei schmerzhaften Raumforderungen in diesem Bereich eingeschlossen werden. In Kenntnis der typischen klinischen Symptome sowie der radiologischen und histopathologischen Befunde ist eine schnelle und zielgerichtete Diagnosestellung möglich.

Abstract

Background

Schwannomas (neurinomas) are among the most frequent peripheral nerve tumors. Nevertheless, these are seldom located in the lower extremities in association with the femoral nerve.

Clinical presentation

In this case, the occurrence of a schwannoma adjacent to the femoral nerve is described in a patient presenting with nonspecific pain in the thigh accompanied by a palpable mass. Sensory and motor deficits were not present. Further examinations by MRI and biopsy followed by histopathology, revealed the diagnosis of a schwannoma. The tumor was completely excised.

Conclusion

Although schwannomas of the lower extremities are rare, they should be included in the differential diagnosis. Knowing the typical clinical symptoms, radiological signs, and histopathological findings, diagnosis should be straight forward.

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Schulte, P., Sandalcioglu, I., Grabellus, F. et al. Das Schwannom des Nervus femoralis. Schmerz 27, 312–316 (2013). https://doi.org/10.1007/s00482-013-1311-4

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