Clinical and Pathological Presentation of Marjolin’s Ulcer as Malignant Peripheral Neural Sheath Tumor

Schwannoma or neurilemmoma is a common soft tissue neoplasm arising from the neural sheath of Schwann cells. However, intraosseous schwannoma is rare, accounting for less than 0.2% of primary bone tumours. Several variants of schwannoma have been reported; among them, intraosseous schwannoma with ancient change is extremely rare. This current report presents an extremely rare case of ancient intraosseous neurilemmoma. The patient presented with right elbow pain and disability. A radiolucent, well-defined, lobulated lesion with a thin sclerotic rim in the proximal ulnar metaphysis that had caused a pathological fracture was noted. The mass was surgically excised using marginal resection and bone curettage was undertaken. The bone deficit was grafted with hydroxyapatite and β-tricalcium phosphate and augmented with bone cement. There were no signs of any recurrence after 3 years. This is the first case of an ancient intraosseous schwannoma of the proximal ulna. Although rare, intraosseous schwannoma should be considered in the differential diagnosis of radiographically benign-appearing osseous tumours in the bone. The cement technique is recommended for the treatment of intraosseous schwannoma.

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Marjolin’s ulcer of the forearm from 30-year-neglection of external fixator

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2021.01.107 ◽

2021 ◽

Vol 80 ◽

pp. 105613

Author(s):

Haidar Kassir ◽

Mohamad K. Moussa ◽

Firass El Hajj ◽

Walid Kheireddine ◽

Mohammad O. Boushnak

Keyword(s):

External Fixator ◽

Marjolin’S Ulcer

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Marjolin’s Ulcer

Chronic Wounds, Wound Dressings and Wound Healing - Recent Clinical Techniques, Results, and Research in Wounds ◽

10.1007/15695_2017_94 ◽

2018 ◽

pp. 85-91

Author(s):

Moises Menendez ◽

Christopher Menendez

Keyword(s):

Marjolin’S Ulcer

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Neurilemoma of the Median Nerve - Surgical Strategies Based on a Case Report

Polish Journal of Surgery ◽

10.2478/pjs-2014-0076 ◽

2014 ◽

Vol 86 (9) ◽

Author(s):

Łukasz Ulatowski ◽

Anna Kaniewska

Keyword(s):

Case Report ◽

Median Nerve ◽

Nerve Trunk ◽

Reconstruction Technique ◽

Nerve Reconstruction ◽

Surgical Strategies ◽

Second Procedure ◽

Relationship Of ◽

The Relationship ◽

Neural Sheath

AbstractThe study presented a case of a patient with a neurilemoma of the median nerve. It presented as a six centemeters tumor, at the level of the proximal one third of the arm with only mild paraesthesias within frst to third ray of the hand. MRI showed the relationship of the tumor and the median nerve, and allowed for the preliminary diagnose of a benign peripheral neural sheath tumor (neurilemoma or neurofibroma). During the first operation the tumor has not been excised, because nerve reconstruction technique was not available. During the second procedure excision of the tumor has been performed without resection of the median nerve trunk with no postoperative deficiencies. The paper provides a detailed description of a surgical procedure. The presented case, like current publications shows that peripheral neural sheath tumor may be usually excised without resection of the nerve trunk, although the possibility of nerve fascicles injury or the need to excise them in the case of neurofibroma clearly suggest that these type of operations should be carried out in centers with microsurgical facilities.

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