A Rare Case Report on Neurilemmoma of the Superficial Peroneal Nerve and a Review of the Literature

Abstract

Neurilemmoma is a form of nerve tumor that develops from the nerve sheaths. It is a slow-growing tumor with a rare malignant transformation. It has an incidence rate of less than 1% in lower limbs and its origin in the superficial peroneal nerve is an extremely rare occurrence. In this report, we present a case of neurilemmoma of the superficial peroneal nerve in a 67-year-old male who presented with complaints of pain and swelling at the lateral aspect of the leg. The swelling was enucleated while preserving the main nerve trunk. The patient was found to be asymptomatic after a two-year postoperative period.

Keywords: musculoskeletal tumor; nerve root preserving; oncosurgery; peripheral schwannoma; rare cancer.

Figure 1. Painful bulge on the lateral aspect of the patient’s left leg along with previous surgical scar mark

Figure 2. MRI images

The images show a lesion measuring approximately 2.3 x 1.9 x 1.5 cm with internal tiny cystic changes seen arising from the left superficial peroneal nerve on the lateral aspect of the left lower leg: (A) T2 images show the hyperintense lesion while hypointensity is seen in T1 images (B, C) MRI: magnetic resonance imaging

Figure 3. Tumor margins arising from peroneal nerve trunk

Figure 4. Enucleated tumor mass along single nerve fibers

Figure 5. Completely excised tumor mass with preserved nerve root