These are benign, slow growing nerve tumors that can occur anywhere in the peripheral nervous system. Generally patients discover a painless, firm lump. Though these tumors form within nerves and are surrounded by normal nerve fibers, they are easily separated from the nerve and removed by an experienced peripheral nerve surgeon.
These are the most common nerve tumors operated on by non-peripheral nerve surgeons. Tragically, these patients undergo a “lymph node biopsy,” only to awaken with permanent weakness, numbness, and pain, only to find to the horror of patient and surgeon that they indeed had a nerve tumor instead.
Figure 1. MRI demonstrating a schwannoma involving the right saphenous nerve (T).
Figure 2. Intraoperative photograph showing the saphenous nerve schwannoma seen on MRI in Figure 1, surrounded by normal nerve fascicles. Careless resection of these tumors by those not trained in peripheral nerve surgery can damage these vital neural elements, resulting in severe neurological deficits and chronic pain.
Figure 3. Intraoperative photograph showing an intact saphenous nerve (N) following complete removal of the schwannoma.
Figure 4. Intraoperative photograph of the schwannoma following excision from the parent nerve.