Background: Schwannomas are benign peripheral nerve sheath tumors arising from Schwann cells, most commonly affecting the median nerve in the upper extremity. Although typically slow-growing and asymptomatic, they can present with pain, swelling, or neurologic symptoms due to nerve compression. Accurate diagnosis and appropriate management are crucial to ensure complete resection and preservation of nerve function.Case Presentation: We report a case of a 30-year-old male presenting with a 3-year history of a painless, gradually enlarging swelling on the medial aspect of the distal left arm. On examination, a 6×6 cm, well-circumscribed, soft, and tender mass was noted, with mild motor weakness in thumb opposition and finger flexion. Magnetic resonance imaging (MRI) revealed a well-defined lesion within the muscular plane, arising from the median nerve, consistent with a benign peripheral nerve sheath tumor. The patient underwent complete surgical excision with preservation of the nerve fascicles, without the need for nerve grafting. Histopathological examination confirmed the diagnosis of schwannoma. Postoperatively, the patient experienced no new neurological deficits and showed clinical improvement.Conclusion: This case highlights the importance of considering schwannomas in the differential diagnosis of soft tissue masses in the upper limb, particularly when associated with subtle neurological findings. Imaging modalities such as MRI and ultrasonography play a key role in preoperative assessment. Surgical enucleation remains the treatment of choice, offering excellent outcomes with low recurrence rates and preservation of nerve function. This report reinforces current literature on the clinical presentation, diagnostic approach, and successful management of median nerve schwannomas.
Shah et al. (Thu,) studied this question.