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Washington University Experience | NEOPLASMS - CRANIAL AND PARASPINAL NERVEs | Perineurioma, Intraneural | 2A0 Case 2 History
Case 2 History ---- The patient is an 11-year-old boy with a history of a congenital right-sided sciatic neuropathy, characterized by stable persistent weakness in the right lower leg. Currently the patient has fatigue with distance walking, and uses a wheelchair to traverse longer distances. He has undergone removal of a "tumor" from the dorsum of the right foot in infancy, reportedly a fibrous tumor attached to the nerve. He has limb length discrepancy, and has undergone several orthopedic procedures as well as treatment with growth plate inhibitor to attempt normalization of this discrepancy. The MRI shows expansion and post-contrast enhancement of the proximal sciatic nerve, a pattern more consistent with a classical mass-like appearance of perineurioma. MRI shows enlargement of the sciatic nerve. The patient has both motor and sensory nerve functional changes in the right sciatic distribution. Operative procedure: Right gastrocnemius muscle biopsy and right sural nerve biopsy. A pathology report from an OSH describes the patient's right foot "tumor," resected 10 years prior, as a "ganglion cyst." Accepting that diagnosis at face value, it is unlikely to bear directly on the current pathology.
