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DOI: 10.1055/s-0033-1357268
Schwannoma of the Pudendal Nerve at Sciatic Notch and Differential Diagnosis of “Sitting Pain”
Publication History
28 July 2013
31 July 2013
Publication Date:
03 March 2014 (online)
The histopathology and clinical behavior of the peripheral nerve sheath tumor known as a schwannoma is well described, and reviews continue to be published.[1] [2] While the pudendal nerve has been identified as the source of a neurofibroma,[3] and as the recipient of a metastatic lesion,[4] it has never been described with a schwannoma. It is the purpose of this report to describe a patient presenting with “sciatica” who had a schwannoma of the pudendal nerve at the sciatic notch. The difference in physical examination and history related to “pudendal neuralgia” versus “sciatica” is reviewed. A surgical approach is described that resulted in relief of the patient's symptoms. The differential diagnosis of pain with sitting is reviewed as it relates to the sciatic, posterior femoral cutaneous and pudendal nerves.
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References
- 1 Woertler K. Tumors and tumor-like lesions of peripheral nerves. Semin Musculoskelet Radiol 2010; 14 (5) 547-558
- 2 Rodriguez FJ, Folpe AL, Giannini C, Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol 2012; 123 (3) 295-319
- 3 Bontoux D, Alcalay M, Reboux JF, Barbier J. A case of neurofibroma of the internal pudendal nerve [in French]. Rev Rhum Mal Osteoartic 1975; 42 (4) 297-300
- 4 Thomas E, Abiad L, Cyteval C , et al. Metastatic pudendal nerve compression presenting as atypical sciatica. J Spinal Disord Tech 2002; 15 (4) 324-325
- 5 Vancaillie T, Eggermont J, Armstrong G, Jarvis S, Liu J, Beg N. Response to pudendal nerve block in women with pudendal neuralgia. Pain Med 2012; 13 (4) 596-603
- 6 Hibner M, Desai N, Robertson LJ, Nour M. Pudendal neuralgia. J Minim Invasive Gynecol 2010; 17 (2) 148-153
- 7 Dellon AL. Chronic pelvic pain. Pain Solutions. Available at: http://www.dellon.com/ps/chapter12.pdf
- 8 Jacobs WC, van Tulder M, Arts M , et al. Surgery versus conservative management of sciatica due to a lumbar herniated disc: a systematic review. Eur Spine J 2011; 20 (4) 513-522
- 9 Ailianou A, Fitsiori A, Syrogiannopoulou A , et al. Review of the principal extra spinal pathologies causing sciatica and new MRI approaches. Br J Radiol 2012; 85 (1014) 672-681
- 10 Ashworth J, Konstantinou K, Dunn KM. Prognostic factors in non-surgically treated sciatica: a systematic review. BMC Musculoskelet Disord 2011; 12: 208-211
- 11 Colebunders B, Matthew MK, Broer N, Persing JA, Dellon AL. Benjamin Alcock and the pudendal canal. J Reconstr Microsurg 2011; 27 (6) 349-354
- 12 Chhabra A, Williams EH, Wang KC, Dellon AL, Carrino JA. MR neurography of neuromas related to nerve injury and entrapment with surgical correlation. AJNR Am J Neuroradiol 2010; 31 (8) 1363-1368