GAsymptomatic Ulnar Nerve Neurilemmoma Masquerading as a Lipoma

Special Article - Surgical Case Reports

Austin J Surg. 2015;2(3): 1057.

GAsymptomatic Ulnar Nerve Neurilemmoma Masquerading as a Lipoma

Wani Bhushan N¹* and Jajoo Suhas N²

¹Department of Surgery, MVPS DVP Medical College,India

²Department of Radiodiagnosis, Jawaharlal Nehru Medical College, India

*Corresponding author: Wani Bhushan N,Department of Surgery, MVPS’s Dr. Vasantrao Pawar Medical College, Nashik, India

Received: November 24, 2014; Accepted: March 18, 2015;Published: April 02, 2015


Peripheral nerve tumours are rare, the commonest being the (benign) neurinoma which usually presents with mild symptoms or even no neurological deficit. Here in our case, patient came with mild, diffuse mass and discomfort. The clinical neurological examination was not conclusive. Asymptomatic unexpected neurilemmoma of the ulnar nerve was excised considering it as lipoma. After surgery its nervous origin was confirmed and the histopathological examination confirmed the diagnosis of neurilemmoma. Point to remember is that, even a surface lesion that appears benign, it should be seriously considered peripheral nerve sheath tumours as a possible differential diagnosis.

Keywords: Neurilemmoma; Schwannoma; Neurofibroma; Lipoma


Peripheral nerve tumours are rare, the commonest being the (benign) neurinoma [1]. In 1910 Verocay had first time postulated that neurinoma has histologically to be distinguished from neurofibromas [2] and it also arises from Schwann cells [3]. In the literature the tumor is called Neurilemmoma or Schwannoma (because of its origin). They can present with mild symptoms or even no neurologic deficit, so difficulty in diagnosis clinically is common and they have been confused with lipomas, haemangiomas, neurofibromas, etc. [1,3]. Careful dissection is of paramount important during the surgery, to prevent unfortunate resection of the nerve. An ample degree of attention is necessary for the inclusion of peripheral nerve tumours as a differential diagnosis of an upper extremity mass [3].


A 38 years old man presented with a swelling over posterior compartment of the arm. It was first noticed 4-5 years ago after he had had an injury over the area, but lately it has been associated with dull pain and discomfort (Figure 1). He had no significant past medical or family history. There were no other systemic symptoms. On examination, there was a non-tender, firm, deep swelling, free from the skin with restricted mobility in vertical axis over the extensor compartment of the arm. The surrounding skin was normal without any scars or pigmented areas. The clinical neurological examination was without any deficit and not conclusive. No biopsy was undertaken before definitive surgery, considering benignity at clinical and imaging examination of swelling.