A Case of Schwannoma of Ulnar Nerve Extirpating with Secondary Push Out Method

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In the extirpation of the intramedullary spinal cord tumor, the secondary push-out method by Elsberg was carried out so far.A 28 year old man with ulnar nerve schwannoma in the distal aspect of left upper arm was carried out the extirpation. Since the demarcation between the tumor and nerve fibers was not clear and the primary extirpation was afraid likely the nerve injury, the incision of epineurium was only performed and the wound was closed temporarily.At the reoperation after one week, the tumor was localized and pushed out medially. And then this tumor was extirpated easily without injury of healthy nerve fibers.The postoperative course was uneventful, and the shooting pain radiating from the medial side of upper arm to the left 4th and 5th fingers was disappeared completely after surgery. There were not the functional disturbance of the hand and fingers.It is noted that the secondary push-out method by Elsberg is able to apply for the tumor extirpation of peripheral nerve.Otherway, it was also reported a case of the great intramedullary tumor (lipoma) extirpating with this method.