Tumors and Tumor-Like Lesions Mimicking Peripheral Neuropathies

Tumors and tumor like lesions are a rare cause of peripheral neuropathy at the upper extremity. Because of the rarity of the disease, the diagnosis is often delayed. In cases of atypical clinical presentation, a high index of suspicion and a detailed neurologic examination, along with the palpation of a mass are necessary to differentiate idiopathic, metabolic, inflammatory or traumatic neuropathy from a tumor related peripheral neuropathy. These lesions may be intra- or extra-neural, benign or malignant, and usually belong to one of the following categories: lipomatous tumors, ganglion and synovial cysts, reactive and inflammatory lesions, peripheral nerve sheath tumors, compression from lymph nodes and nerve lymphomatosis, metastatic disease to brachial plexus and peripheral nerves, and sarcomas. The treatment of these lesions includes decompression of the entrapped nerve and subsequent procedures according to the characteristics (location, extent, aggressiveness) of the lesion.