• Nikhil K Murthy, Karen J Fritchie, Kimberly K Amrami, Peter S Rose, and Robert J Spinner.
• Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
• World Neurosurg. 2020 Sep 1; 141: 363-366.

BackgroundNeuritis ossificans (intraneural heterotopic ossification) is a rare disorder described as heterotopic ossification of a nerve. We describe the presentation and management of the first reported case of neuritis ossificans with diffuse brachial plexus involvement and review the literature.Case DescriptionA 35-year-old man presented to our clinic for evaluation of right upper extremity weakness without history of trauma. He had significant, debilitating pain and magnetic resonance imaging demonstrated a complex contrast-enhancing mass with significant associated edema. Positron emission tomography demonstrated a 18F-fluorodeoxyglucose avid lesion within the brachial plexus that was confirmed by biopsy to be neuritis ossificans. The patient was treated with indomethacin and had clinical and radiologic improvement.ConclusionsWe present the only case of diffuse, brachial plexus neuritis ossificans. Given the challenges of resecting neuritis ossificans in this region, we believe medical management for complex brachial plexus lesions should be considered first, unless the sequela of the disease is sufficiently prolonged or there is concern for permanent neurovascular compromise.Copyright © 2020 Elsevier Inc. All rights reserved.

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