Intraneural perineuriomas: diagnostic value of magnetic resonance neurography

Abstract Intraneural perineurioma is an under‐recognized hypertrophic peripheral nerve tumor. It affects young patients involving frequently the sciatic nerve and its branches and presents with a progressive, painless and predominantly motor deficit. Magnetic resonance neurography is a useful tool to localize the lesion, evaluate its extension, and discriminate between different etiologies. We reviewed the clinical records of 11 patients with pathologically confirm intraneural perineurioma. Eight patients were males with mean age 19 years. Initial complains were unilateral stepagge (7 patients), bilateral stepagge (1 patient), unilateral gastrocnemius wasting (1 patient), unilateral thigh atrophy (1 patient) and unilateral hand weakness (1 patient). Nine patients had mild painless sensory loss. Examinations revealed involvement of sciatic nerve extending into the peroneal nerve (8 patients), posterior tibial nerve (1 patient), radial nerve (1 patient) and femoral nerve (1 patient). Magnetic resonance neurography revealed enlargement of the affected nerve isointense on T1‐weighted, hyperintense on T2 fat saturated images, and with avid enhancement on post‐contrast imaging. In all patients, a nerve biopsy confirmed the diagnosis. Magnetic resonance neurography allows early and non‐invasive identification of this tumor and is a key tool providing localization and differential diagnosis in patients with slowly progressive focal neuropathies.
Source: Journal of the Peripheral Nervous System - Category: Neurology Authors: Tags: RESEARCH REPORTS Source Type: research