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Tumoración quística en el muslo: Schwannoma del nervio ciático con diagnóstico inicial de quiste hidatídico, un caso clínico

Cystic tumor in the thigh: Schwannoma of the sciatic nerve with initial diagnosis of hydatid cyst, a clinical case

MONÍS GARCÍA A, MIRANDA GÓMEZ I, OLMO VALERIANO I, MORENO VADILLO M, COLADO DOMÍNGUEZ J, SANGÜESA NEBOT MJ, DOMÉNECH FERNÁNDEZ J. SERVICIO DE CIRUGÍA ORTOPÉDICA Y TRAUMATOLOGÍA. HOSPITAL ARNAU DE VILANOVA, VALENCIA, ESPAÑA.
Recepción:
25/01/2022
Aceptación:
25/01/2022
Publicación:
25/01/2022


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Resumen (ES)

Introduction: hydatid cysts are produced by the Echinococcus granulosus parasite. The single location in the muscles is rare.
The cystic mass can be confirmed by ultrasound or magnetic resonance imaging (MRI) and its differential diagnosis may be
difficult. Material and method: We present a case with a tumorous mass in thigh with MRI report: "encapsulated cystic lesion
dependent on the biceps femoris, which contacts the sciatic neurovascular bundle, being the 1st diagnostic possibility hydatid
cyst". Mebendazole was prescribed and after a month the tumor was excised, which was not located within the muscle but
rather pushing it, attached to the sciatic nerve. Diagnosis after anatomopathological study was sciatic schwannoma.
Discussion and conclusion: on MRI, schwannomas are usually seen as a mass adhered and eccentric to a nerve, but they
can present cystic degeneration mimicking hydatidic cyst; Faced with a single muscular or perimuscular cystic tumor, close to
the neurovascular bundle, with negative systemic tests for parasite disease, the schwannoma should be taken into account in
the differential diagnosis

Palabras clave (ES):

schwannoma;
cystic
mass;
sciatic
nerve
hydatid
cysts;

Resumen (EN)

Introduction: hydatid cysts are produced by the Echinococcus granulosus parasite. The single location in the muscles is rare.
The cystic mass can be confirmed by ultrasound or magnetic resonance imaging (MRI) and its differential diagnosis may be
difficult. Material and method: We present a case with a tumorous mass in thigh with MRI report: "encapsulated cystic lesion
dependent on the biceps femoris, which contacts the sciatic neurovascular bundle, being the 1st diagnostic possibility hydatid
cyst". Mebendazole was prescribed and after a month the tumor was excised, which was not located within the muscle but
rather pushing it, attached to the sciatic nerve. Diagnosis after anatomopathological study was sciatic schwannoma.
Discussion and conclusion: on MRI, schwannomas are usually seen as a mass adhered and eccentric to a nerve, but they
can present cystic degeneration mimicking hydatidic cyst; Faced with a single muscular or perimuscular cystic tumor, close to
the neurovascular bundle, with negative systemic tests for parasite disease, the schwannoma should be taken into account in
the differential diagnosis

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