Abstract
Peripheral nerve tumors are uncommon, nerve sheath tumors, schwannoma and neurofibromas being the most frequent. Their clinical signs and symptoms are often unspecific, which is why they may pose a diagnostic problem; this is particularly true for the neck, where a palpable mass is often mistaken for an enlarged lymph node by the referring clinician. Several neurogenic tumors can affect the musculoskeletal system, including traumatic neuroma, Morton’s neuroma, neural fibrolipoma, nerve sheath ganglia, neurilemmoma, neurofibroma and malignant peripheral nerve sheath tumors (Murphey et al. 1999). In general the diagnosis of such a lesion is based on the detection of a mass in association with neurologic signs. It is important, however, to delimitate musculoskeletal lesions with secondary nerve involvement from lesions directly derived from neurogenic tissue. In this regard imaging may be helpful, but only if the applied method has the potential to establish the diagnosis by demonstration of a lesion in direct continuity with a peripheral nerve.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Beggs I (1999) Sonographic appearances of nerve tumors. J Clin Ultrasound 27:363–368
Bencardino J, Rosenberg ZS, Beltran J et al. (2000) Morton’s neuroma: is it always symptomatic. AJR Am J Roentgenol 175:649–653
Bendix N, Wolf C, Gruber H, Bodner G (2005) Ultrasound of tumours and tumour-like lesions of peripheral nerves. Ultraschall Med 26:318–324 (German)
Bodner G, Schocke M, Rachbauer F et al. (2002) Differentiation of malignant and benign musculoskeletal tumors: combined color Doppler ultrasonography, power Doppler ultrasonography and spectral wave analysis. Radiology 223:410–416
Bossley CJ, Cainey PC (1980) The intermetatarsophalangeal bursa: its significance in Morton’s metatarsalgia. J Bone Joint Surg [Br] 62-B:184–187
Fornage BD (1988) Peripheral nerves of the extremities: imaging with ultrasound. Radiology 167:179–182
Gandolfo N, Martinoli C, Cafiero F et al. (2000) Malignant melanoma of soft tissues (clear cell sarcoma) of the foot. Is MRI able to perform a specific diagnosis? Report of one case and review of the radiological literature. Anticancer Res 20:3993–3998
Giovagnorio F, Martinoli C (2001) Sonography of the cervical vagus nerve: normal appearance and abnormal findings. AJR Am J Roentgenol 176:745–749
Gruber H, Glodny B, Bendix N, Tzankov A, Peer S (2007) High-resolution ultrasound of peripheral neurogenic tumors. Eur Radiol 17:2880–2888
Hughes DG, Wilson DJ (1986) Ultrasound appearances of peripheral nerve tumors. Br J Radiol 59:1041–1043
Isobe K, Shimizu T, Akahane T, Kato H (2004) Imaging of ancient schwannoma. AIR Am J Roentgenol 183(2):331–336
Johnstone AJ, Beggs I (1994) Ultrasound imaging of softtissue masses in the extremities. J Bone Joint Surg Br 76:688–689
Katz MR, Lenobel MI (1970) Intraneural ganglion cyst of the peroneal nerve. J Neurosurg 32:692–694
Kransdorf M, Murphey MD (1997) Neurogenic tumors. In: Imaging of soft tissue tumors. Saunders, Philadelphia, pp 235–273
Llanos LF, Vila J, Nunez-Samper M (1999) Clinical symptoms and treatment of the foot and ankle nerve entrapment syndromes. Foot and Ankle Surgery 5:211–218
Leijten FS, Arts WF, Puylaert JB (1992) Ultrasound diagnosis of an intraneural ganglion cyst of the peroneal nerve. J Neurosurg 76:538–540
Lin J, Jacobson JA, Hayes CW (1999) Sonographic target sign in neurofibroma. J Ultrasound Med 18:513–517
Martinoli C, Serafini G, Bianchi S et al (1996) Ultrasonography of peripheral nerves. J Peripheral Nervous System 1:169–174
Masciocchi C, Innacoli M, Cisternino S et al. (1992) Myxoid intraneural cysts of external popliteal ischiadic nerve. Eur Radiol 14:52–55
Mason ML (1953) Presentation of cases. In: Proceedings of the American Society for Surgery of the Hand. J Bone Join Surg [Am] 35:273–275
Morton TG (1876) A peculiar and painful affection of the fourth metatarsophalangeal articulation. Am J Med Sci 71:37–45
Murphey MD, Smith WS, Smith SE et al. (1999) From the archives of the AFIP: imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radio-Graphics 19:1253–1280
Mulder JD (1951) The causative mechanisms in Morton’s metatarsalgia. J Bone Joint Surg [Br] 33-B:74–95
Peer S, Kovacs P, Harpf C et al. (2002) High resolution sonography of lower extremity peripheral nerves: anatomic correlation and spectrum of pathology. J Ultrasound Med 21:315–322
Puig S, Turkof E, Sedivy R et al. (1999) Sonographic diagnosis of recurrent ulnar nerve compression by ganglion cysts. J Ultrasound Med 18:433–436
Quinn TJ, Jacobson JA, Craig JG, van Holsbeeck (2000) Sonography of Morton’s neuromas. AJR Am J Roentgenol 174:1723–1728
Redd RA, Peters VJ, Emery SF et al. (1989) Morton Neuroma: sonographic evaluation. Radiology 171:415–417
Reynolds DL Jr, Jacobson JA, Inampudi P, Jamadar DA, Ebrahim FS, Hayes CW (2004) Sonographic characteristics of peripheral nerve sheath tumors. AJR Am J Roentgenol 182:741–744
Roos KL, Muckway M (1995) Neurofibromatosis. Dermatol Clin 13:105–111
Shapiro PP, Shapiro SL (1995) Sonographic evaluation of interdigital neuromas. Foot Ankle 16:604–606
Shereff MJ, Grande DA (1991) Electron microscopic analysis of the interdigital neuroma. Clin Orthop 271:296–299
Silverman TA, Enzinger FM (1985) Fibrolipomatous hamartoma of nerve: a clinicopathologic analysis of 26 cases. Am J Surg Pathol 9:7–14
Simonovsky V (1997) Peripheral nerve schwannoma preoperatively diagnosed by sonography: report of three cases and discussion. Eur J Radiol 25:47–51
Spinner RJ, Atkinson JL, Tiel RL (2003) Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 99:330–343
Spinner RJ, Amrami KK, Wolanskyj AP et al. (2007) Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg 107:296–307
Wanebo JE, Malik JM, Vandenberg SR et al. (1993) Malignant peripheral nerve sheath tumors: a clinicopathological study of 28 cases. Cancer 71:247–252
Weiss S, Goldblum J (2001) Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby, St Louis
Yamazaki H, Saitoh S, Seki H (1999) Peroneal nerve palsy caused by intraneural ganglion. Skeletal Radiol 28:52–56
Zanetti M, Strehle JK, Zollinger H et al. (1997) Morton neuroma and fluid in the intermetatarsal bursae on MR images of 70 asymptomatic volunteers. Radiology 203:516–520
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Bodner, G., Peer, S. (2008). Tumors and Tumor-Like Lesions. In: Peer, S., Bodner, G. (eds) High-Resolution Sonography of the Peripheral Nervous System. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-49084-5_6
Download citation
DOI: https://doi.org/10.1007/978-3-540-49084-5_6
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-49083-8
Online ISBN: 978-3-540-49084-5
eBook Packages: MedicineMedicine (R0)