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Choroid Plexus Carcinoma - Lateral Ventricle
Joseph Junewick, MD FACR
over 6 years ago
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Phrenic Nerve Neurofibroma

Case Detail

Anatomy: Neck-Face
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 5 years ago
Updated: over 5 years ago
Tags: PEDS
Modality/Study Types: MR
Activities:
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History

Adult with dysphagia and neurofibromatosis.


Case Images


Diagnosis

Phrenic Nerve Neurofibroma

Findings

MR – Axial and coronal T2 and axial T1 and post-gadolinium T1 images of the neck show an ovoid mass anterior to the right scalene muscle with distortion of the larynx.

Discussion

Fibers from the 3rd, 4th and 5th cervical nerves join to form the phrenic nerve. It descends obliquely along the anterior scalene muscle, deep to the prevertebral layer of deep cervical fascia between the subclavian artery and vein before entering the mediastinum. The phrenic nerves provide motor innervation to the diaphragm, sensory innervation to the central intrathoracic and peritoneal surfaces of the diaphragm, and sensory innervation of the pericardium and mediastinal pleura (mediating pain to the neck and shoulder). Manifestations of phrenic nerve disease include diaphragmatic paralysis with elevation or persistent hiccups. Primary tumors of the phrenic nerves are rare but are seen in neurofibromatosis. Metastatic disease involvement from primary lung cancer is more common.

Reference

Aquino SL, Duncan GR, Hayman LA. Nerves of the Thorax: Atlas of Normal and Pathologic Findings. Radiographics (2001); 21:1275-1281

Contributor

Carol Bosanko, MD



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