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Sciatic schwannoma presenting as deep gluteal syndrome: a case report
Arthrosc Orthop Sports Med 2021;8:67-70
Published online November 1, 2021;  https://doi.org/10.14517/aosm21006
© 2021 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Yoshi Pratama Djaja1,2, Jae-Sung Lee1, Yong-Chan Ha1, Young-Ho Roh3

1Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea, 2Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Jakarta, Indonesia, 3Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju, Korea
Correspondence to: Young-Ho Roh, https://orcid.org/0000-0002-0703-4970
Department of Orhopaedic Surgery, Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea. Tel: +82-64-717-1690, Fax: +82-64-717-1690, E-mail: shdudgh0302@gmail.com
Received July 21, 2021; Revised August 23, 2021; Accepted September 17, 2021.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Cystic degeneration of a schwannoma of the sciatic nerve occurs very rarely, especially in small lesions; thus, it may pose a challenge in diagnosis. This report describes the case of a 58-year-old referred woman patient with a 1-year history of discomfort in the left gluteal region without any radicular symptoms. Magnetic resonance imaging revealed a 3.3-cm cystic mass located adjacent to the sciatic nerve, which raised suspicion of a paralabral cyst owing to the stalk-like structure connecting the mass and posterior hip labrum. Hip arthroscopy was performed for deep gluteal region exploration, revealing that the lesion tightly adhered to the sciatic nerve. Open microsurgery was then performed to remove the lesion. Postoperatively, the patient’s complaints were resolved, and neurological complications were not found. Histological examination corresponded to a benign schwannoma. Complications and recurrence were not observed at the 1-year follow-up. Benign schwannoma should be considered as a differential diagnosis for a purely cystic lesion around the sciatic nerve, and awareness thereof should be increased. A further diagnostic approach should be established preoperatively to determine the best course of treatment.
Keywords : Sciatic nerve; Schwannoma; Peripheral nerve sheath tumor; Paralabral cyst; Deep gluteal syndrome
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