C A S E O F T H E M O N T H
BRACHIAL PLEXUS TUMOR
A 50-year-old man complained of left arm discomfort and occasional tingling and numbness for the past 5 years. Recently, he also noted a lump above his left collarbone, which he could feel right under the skin. When he pressed on the mass, he would experience a tingling sensation in his left arm. The episodes of tingling and numbness also became more frequent, especially when he lifts heavy objects. This prompted consult.
On examination, there was a round, slightly movable mass beneath the skin above the patient’s left collarbone. He had no arm weakness and no numbness during the examination.
MRI of the brachial plexus showed a well-defined mass compressing the brachial plexus, a large and important bundle of nerves that supply strength and sensation to the arm. Because the mass was fairly large and causing a lot of symptoms, surgery was recommended.
The patient underwent brachial plexus exploration and excision of the mass. A nerve stimulator was used during surgery to help identify the nerve elements surrounding the mass, so as to avoid damaging the nerves or cutting into them. The mass was completely removed, and the patient did not develop any weakness or numbness after the surgery. Histopathology showed that the mass was a schwannoma, a benign nerve tumor. |
