Neurilemmomas of the forearm and hand

Neurilemmoma is the most common tumor arising from peripheral nerves. Although infrequently encountered, it must be included in the differential diagnosis of soft tissue tumors. Because of its cystic consistency, a neurilemmoma in the hand or wrist may be mistaken for a ganglion. In this series of 17 neurilemmomas, 6 were present in the forearm, and 11 were in the hand and wrist. There were 5 tumors in fingers, 1 in the thumb, 3 in the palm, and 2 in the wrist. In the forearm, 3 tumors involved the median nerve, 2 involved the ulnar nerve, and 1 arose from a small sensory branch of the radial nerve. Neurilemmomas arise from a benign proliferation of the Schwann cells and rarely disturb the function of the involved nerve. The tumors are well encapsulated and may be easily enucleated from the parent nerve. Resection of the involved nerve is seldom necessary except when small nerves are extensively involved.