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Metastatic adenocarcinoma of radial nerve

Published:September 23, 2022DOI:https://doi.org/10.1016/j.amjms.2022.09.012

      Case presentation

      A 49-year-old woman presented with a month history of right wrist drop and thumb numbness. Electromyography/evoked potential examination indicated neurogenic damage of the right radial nerve at the spiral groove of the humerus. During exploration of the radial nerve, a tumor of 3 cm in length was attached to the nerve on the level of upper deltoid ending point (Fig. 1A). The tumor was hard, with complete capsule. The tumor was separated from the nerve and excised completely. Pathological examination indicated metastatic poorly differentiated adenocarcinoma (Fig. 1B), with the following immunohistochemistry results: CK (+) (Fig. 1C), CK7 (+) (Fig. 1D), CK18 (+) (Fig. 1E), Vimentin (+), CK20 (-), TTF-1 (-), HMB45 (-). Subsequent chest computed tomography demonstrated a lobulated nodular soft tissue density in the left upper lobe adjacent to the pleura (Fig. 1F). The patient died 1 year after diagnosis of lung cancer.
      Peripheral nerve tumors are usually classified into neural sheath and nonneural sheath tumors. Peripheral neural sheath tumors include schwannomas, neurofibromas, and peripheral nerve sheath malignant tumors. Peripheral nonneural sheath tumors include granular cell tumor, ganglion cyst, lipoma, reactive lymphoid follicular hyperplasia.
      • Kim D.H.
      • Murovic J.A.
      • Tiel R.L.
      • et al.
      A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center.
      ,
      • Kim D.H.
      • Murovic J.A.
      • Tiel R.L.
      • et al.
      A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center.
      Isolated peripheral nerve metastasis is a relatively rare phenomenon, which should be considered in the context of primary malignant tumor.

      Source of funding

      The author(s) received no financial support for the research, authorship, and/or publication of this article.

      Declaration of Competing Interest

      The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this manuscript.

      References

        • Kim D.H.
        • Murovic J.A.
        • Tiel R.L.
        • et al.
        A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center.
        J Neurosurg. 2005; 102: 256-266
        • Kim D.H.
        • Murovic J.A.
        • Tiel R.L.
        • et al.
        A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center.
        J Neurosurg. 2005; 102: 246-255