Saravanan K, Nagappan PG, Simpson AI. Benign but not inconsequential, paediatric sciatic nerve neuromuscular choristoma and its longitudinal impact: A case report. World J Clin Cases 2026; 14(15): 120061 [DOI: 10.12998/wjcc.v14.i15.120061]
Corresponding Author of This Article
Ashley Iain Simpson, Consultant, FRCS, Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Brockley Hill, London HA7 4LP, United Kingdom. ashley.simpson@nhs.net
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
May 26, 2026 (publication date) through May 12, 2026
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Journal Information of This Article
Publication Name
World Journal of Clinical Cases
ISSN
2307-8960
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Saravanan K, Nagappan PG, Simpson AI. Benign but not inconsequential, paediatric sciatic nerve neuromuscular choristoma and its longitudinal impact: A case report. World J Clin Cases 2026; 14(15): 120061 [DOI: 10.12998/wjcc.v14.i15.120061]
Karthik Saravanan, School of Medicine and Biomedical Sciences, Queen’s College, University of Oxford, Oxford OX1 4AW, United Kingdom
Palaniappan Ganesh Nagappan, Ashley Iain Simpson, Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, London HA7 4LP, United Kingdom
Author contributions: Saravanan K, Nagappan PG and Simpson AI were all equally involved with addressing the reviewer comments and implementing these into the edited manuscript for re-submission.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Ashley Iain Simpson, Consultant, FRCS, Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Brockley Hill, London HA7 4LP, United Kingdom. ashley.simpson@nhs.net
Received: February 14, 2026 Revised: March 12, 2026 Accepted: April 22, 2026 Published online: May 26, 2026 Processing time: 88 Days and 5.1 Hours
Abstract
BACKGROUND
Neuromuscular choristoma (NMC) is a rare developmental anomaly characterised by the aberrant presence of mature skeletal muscle fibres within peripheral nerve fascicles. Involvement of the sciatic nerve is uncommon, with most reported instances limited to isolated case reports in paediatric patients. The natural history, long-term neurological stability, and optimal management of this condition remain poorly defined in the literature.
CASE SUMMARY
We describe a paediatric patient who was diagnosed in infancy with a sciatic nerve NMC, confirmed by open biopsy, and has been followed for over ten years. Neurologically, the patient remained stable, exhibiting only mild weakness in the left posterior compartment of the leg. Serial imaging over the follow-up period showed no significant progression or malignant transformation of the lesion. However, over time a progressive limb length discrepancy and lower limb muscle imbalance developed, eventually becoming the dominant clinical issues. A multidisciplinary evaluation supported continued conservative management of the nerve lesion. Ultimately, it was the orthopaedic sequelae, rather than any neurological deterioration, that necessitated intervention. As the patient approached puberty, a guided growth (epiphysiodesis) procedure was performed to address the limb length discrepancy.
CONCLUSION
Our case adds to the limited body of long-term follow-up data and supports a conservative management approach for NMC, with an emphasis on secondary musculoskeletal consequences.
Core Tip: Neuromuscular choristoma (NMC) is a rare benign developmental lesion of peripheral nerves in which mature muscle fibres are intermingled with nerve fascicles. Although NMC is histologically benign, unnecessary surgical intervention can provoke an aggressive desmoid-type fibromatosis in the affected nerve. Paediatric sciatic nerve NMC cases are extremely uncommon, with only one published report providing long-term follow-up. We present an 11-year follow-up of a child with a sciatic NMC, underscoring the significant orthopaedic sequelae that can arise and necessitate complex multidisciplinary management. This under-recognised aspect of NMC care is a key clinical consideration highlighted by our case.
