Unusual presentation of lateral sural cutaneous nerve schwannoma: An exceptional case report.

INTRODUCTION: Schwannoma is the most common benign nerve sheath tumor. Peripheral nerves of the lower extremity are rarely involved and usually asymptomatic. CASE PRESENTATION: We report the case of a misleading clinical presentation of lateral sural cutaneous nerve schwannoma. DISCUSSION: To the best of our knowledge, no case has been reported about the location of schwannoma in the lateral sural cutaneous nerve. MRI and anatomopathologic assessment, after microscopic enucleation, are required to confirm diagnosis. CONCLUSION: Care must be taken to not miss a schwannoma of lateral sural cutaneous nerve by meticulous clinical examination and appropriate imaging using MRI in unexplained L5 sciatica.

Lipomatosis of interdigital nerves: Unusual localization.

Lipomatosis of the nerve (LN) is a rare benign tumor that is characterized by proliferating fibrous fatty tissue surrounding and infiltrating the peripheral nerves. While there are numerous case reports of LN affecting the median nerve and its branches, there are few reports, to the authors' knowledge, of their occurrence in the foot and ankle. A rare case of LN involving the second and third interdigital nerve in a 41-year-old man, which was successfully treated with surgical excision, is reported.

[Sclerotherapy for recurrent glomus tumors]. / Traitement des récidives de tumeurs glomiques par sclérothérapie percutanée.

We report the cases of two women aged 28 and 34 years who presented recurrent glomus tumors of the hand after surgery for marginal resection of the tumor mass. The pathological study of the surgical specimen confirmed the diagnosis of recurrent glomus tumor. Due to the vascular origin of this tumor, sclerotherapy was delivered. The functional outcomes were good with dramatic pain relief within a few days. At 3-year mean follow-up, the cosmetic and functional results were very satisfactory.

[Bilateral capitulum humeri fracture, a case report and review of the literature]. / Fracture bilatérale du capitulum, à propos d'un cas avec revue de la littérature.

Fracture of the capitellum is an intra-articular fracture of the distal humeral metaphysis and usually occurs in the frontal plane. It is a rare fracture and even more unusual when bilateral. The authors report a case of bilateral isolated fracture of the capitellum (Hahn-Steinthal type I) in a woman aged 28 years, treated surgically. A posterolateral approach was used for both elbows. Internal fixation was performed using two Herbert screws in the right elbow, and AO screws in the left elbow. Both elbows were immobilised for 3 weeks before commencing an intensive mobilization program guided by a physiotherapist. The end result was very satisfactory: both elbows were pain-free, with a complete range of movement on the right and a 10 degrees loss of extension on the left. Radiologically, consolidation was complete and there were no signs of avascular necrosis. Based on a review of the literature, the authors favour the use of Herbert screws in the treatment of capitellar fractures. They give good inter-fragmentary compression and reduce the risk of damaging the articular surface due to their subarticular position.

[Tuberculosis of the wrist. Symptoms and outcome in eleven cases]. / Tuberculose du poignet. Symptômes et évolution de 11 cas.

PURPOSE OF THE STUDY: We present our experience with a rare localization of tuberculosis, the wrist, focusing on symptoms and outcome after treatment. MATERIAL AND METHODS: Our series included eleven patients, eight men and three women, mean age 42 Years, who presented tuberculosis of the wrist. Tuberculosis was known in four patients who were being treated and a context of tuberculosis was recognized in three others. One patient on long-term corticosteroid therapy was immunodepressed. Mean time from symptom onset to consultation was fifteen months indicating a slow and progressive disease process. An inflammatory syndrome was noted in nine patients. Based on the standard x-rays, the David-Chausse classification was: stage I n=1; stage II n=1; stage III n=3; stage IV n=4. The AP view of the wrist was normal in two patients. Diagnosis of tuberculosis was confirmed on the surgical biopsy specimen which revealed epithelio-gigantocellulary granuloma with caseous necrosis. In only five patients Koch bacilli developed in culture on Lowenstein-Jensen. Patients were given anti-tuberculous antibiotics and the wrist was immobilized in a plaster splint. RESULTS: Mean follow-up was two years. The disease course was blunted by the antituberculosis treatment. Surgical drainage was only required to clear abscesses. Wrist stiffness was frequent and had a significant functional impact. DISCUSSION: These eleven cases of a rare localization of tuberculosis illustrate the slow progressive course of clinical symptoms and radiological signs of tuberculosis, emphasizing the difficulties encountered in establishing early diagnosis of such isolated non-abscessed localizations. Anti-tuberculous treatment is effective but the functional outcome depends on early diagnosis before the development of radiological evidence of joint destruction.