Surgical intervention for peripheral plexiform schwannoma of the sciatic nerve: a pediatric case study

Abstract

Plexiform Schwannoma, or neurilemmomas, is a rare and benign manifestation of peripheral nerve sheath tumors. The tumor mostly arises from the gradual growth of Schwann cells. These nerve tumors occur in several sites, with the most prevalent being the head, or neck, or even upper extremities. This tumor predominantly manifests in individuals aged 30 to 40 years and is seen equally in both sexes, with these tumors generally measuring less than 2 cm in size. A 14-year-old boy was referred to Oriana Specialty Hospital, Sharjah, UAE, with a one-year history of vague pain in the middle third posterior aspect of the right thigh accompanied by mild tenderness but no peripheral neurological deficit. Magnetic resonance imaging (MRI) of the right thigh revealed a lesion, and a true-cut biopsy confirmed the diagnosis of a peripheral plexiform Schwannoma arising from the sciatic nerve. On 29 December 2024, a surgical excision of the right thigh sciatic nerve Schwannoma was carried out. A posterior midline thigh incision was made, and the procedure was done with advanced techniques, including the use of a microscope and intraoperative nerve stimulator, to ensure precise tumor dissection from the sciatic nerve. The entire Schwannoma, measuring 24×5.5 cm, was successfully excised. There were excellent recoveries post operatively with no neurological deficits or complications of surgery. He was mobilized with full weight-bearing three hours after the surgery and discharged the next day on oral medications. This particular case testifies to the complete excision of a tumor through proper surgery techniques, preserving the neurological function, with promising outcomes for similar cases.