Chronic Large Symptomatic Mass Mimicking And Compressing Peripheral Nerve Tumor: Venous Vascular Malformation
Line Jacques, MD; Beata Durcanova, medical student; Joseph MD Osorio, MD; Cynthia Chin, MD; Andrew Bollen, MD
UCSF, San Francisco, CA
Venous malformations (VM) are a subtype of slow-flowing vascular malformations. They are congenital, continuously growing defects that can create mass effects, compressing surrounding organs and neural structures. VMs and schwannomas can appear similar on imaging, and given the paucity of current literature on VMs masquerading as schwannomas in the cervical region, misdiagnosis does occur. Schwannomas are frequently cited to be misdiagnosed as other malformations, but it is not common for other pathologies, particularly VMs, to be misdiagnosed as schwannomas. This provides an additional challenge in arriving at the correct diagnosis of a VM, which must be suspected before it can be diagnosed. We present two case reports of a 55-year-old woman with a chronic cervical mass due to a VM associated with pain and numbness that was originally misdiagnosed as a schwannoma and a second 45-year-old man patient with a right proximal forearm median nerve neuropathy. The purpose is to illustrate a rare case of misdiagnosis of a VM as a schwannoma in the cervical region in order to prevent similar instances of a diagnostic pitfall in the future. A review of the radiology and intraoperative images and the operative procedure will be presented.
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