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Osteocutaneous radial forearm free flap with bone perfused through anomalous flexor carpi radialis brevis muscle

in treating a benign tumour. At the final follow-up after 1 year, shoulder abduction power was still M4+; no other problems were found. Neuromuscular choristoma is a very rare benign peripheral nerve tumour comprising mature skeletal myofibres of variable sizes in an intimate relationship with nerve fibres. The natural history of this tumour is not fully characterized. Its benign chronic evolution typically results in limb length and girth discrepancy. It presents typically as a solitary lesion in childhood involving cranial nerves and other large peripheral nerves, most commonly the sciatic nerve. HébertBlouin et al. (2012) identified ten patients with a diagnosis of neuromuscular choristoma treated at the Mayo Clinic between 1992 and 2010. They noted that the diagnosis of this tumour might be underreported. MRI findings are described as pathognomonic and should be enough to make the diagnosis and preclude the need of a biopsy (Niederhauser et al., 2013). Up to 30% of excised or biopsied neuromuscular choristoma developed an aggressive fibromatosis (Hébert-Blouin et al., 2012; Oeppen et al., 2003). Despite its rarity, neuromuscular choristoma has characteristic clinical manifestations (i.e. child age, limb length discrepancy) and MRI features that can lead to diagnosis. The present report may alert the surgeon and radiologist to look for clinical presentations and the MRI findings of neuromuscular choristoma to establish the diagnosis and to avoid a biopsy (Marom and Helms, 1999).