Combined manifestation of a neurofibroma and a nerve sheath ganglion in the ulnar nerve after radiotherapy in early childhood.
Occurrence of clinically symptomatic benign neurofibromas of peripheral nerves after radiotherapy is a rarity. We saw a 55-year-old female who developed progressive failure of the ulnar nerve 55 years after 20Gy (226)Ra brachytherapy of a haemangioma of the left elbow at the age of 3 months. Nerve compression at the sulcus segment was caused by the intraneural growth of a neurofibroma and the formation of a nerve sheath ganglion. The rapidly progressive symptoms required operative treatment. Due to the infiltrating tumour growth we decided to resect this segment of the ulnar nerve and reconstruct it with an interfascicular nerve graft. This case demonstrates a rare possible consequence of radiotherapy in which the co-existence of two benign lesions required surgical intervention. Radiotherapy-induced malignant tumours and tissue scarring are well known as complications. The present case suggests further possible late effects of radiotherapy to consider.
Lohmeyer
Jörn Andreas
JA
Department of Plastic, Hand and Reconstructive Surgery, Burn Unit, University of Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. joern.lohmeyer@uni-luebeck.de
Kimmig
Bernhard
B
Gocht
Andreas
A
Machens
Hans-Günther
HG
Mailänder
Peter
P
D001918:Brachytherapy / Q000009:adverse effects*; D005260:Female; D045888:Ganglion Cysts / Q000209:etiology*; D006392:Hemangioma, Cavernous / Q000532:radiotherapy*; D006801:Humans; D008875:Middle Aged; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D009431:Neural Conduction / Q000502:physiology; D009455:Neurofibroma / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome; D014459:Ulnar Nerve / Q000503:physiopathology / Q000528:radiation effects* / Q000601:surgery; D017769:Ulnar Nerve Compression Syndromes / Q000209:etiology* / Q000503:physiopathology