Summary
Peripheral benign nerve sheath tumours are infrequent tumours and affect major nerve trunks. Some authors have indicated a high and prohibitive incidence of neurological injury in resection of these lesions. The authors describe their findings in a retrospective study comprising 119 patients with spontaneous benign nerve sheath tumours of the peripheral nervous system. Seventy-three patients had a schwannoma, 41 had neurofibroma and 5 had plexiform neurofibroma; 25 of the 119 patients suffered from neurofibromatosis. All schwannomas were excised completely and the outcome of patients was 41.0% improved, 6.8% worsened, 52.0% unchanged. Twenty-eight neurofibromas were excised completely and 13 subtotally; the outcome for patients was 19.5% improved, 19.5% worsened and 61% unchanged. All plexiform neurofibromas were removed subtotally and the outcome for patients was 20% improved and 80% unchanged. The best surgical results at average follow-up of 6 years were observed in the patients with schwannoma, the worst in those with plexiform neurofibroma. Our results demonstrated that it is often possible to remove schwannomas as well as neurofibromas with an acceptable risk of injury to the nerve.
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References
Ariel IM (1980) Current concepts in the management of peripheral nerve tumours. In: Omer G, Spinner M (eds) Management of peripheral nerve lesions. Saunders, Philadelphia, pp 669–693
Ariel IM (1988) Tumours of peripheral nervous system. Semin Surg Oncol 4: 7–12
Barre PS, Shaffer JW, Cart JR, Lacey SH (1987) Multiplicity of neurilemomas in the upper extremity. J Hand Surg 12: 307–311
Brooks D (1984) Clinical presentation and treatment of peripheral nerve tumours. In: Dyck P, Lambert E, Thomas P (eds) Peripheral neuropathy. Saunders, Philadelphia, pp 2236–2251
Byrne JJ, Cahill JM (1961) Tumours of major peripheral nerves. Am J Surg 102: 724–727
Burger PC, Vogel FS, Scheithauer BW (1982) Surgical pathology of the nervous system and its coverings. Wiley, New York, pp 649–669
Biga N, Thomine JM, Deshayes P (1987) Difficulties encountered in diagnosing benign solitary neurilemmoma of the popliteal region. Rev Rheum 54: 435–436.
Butt M, Annan JH (1981) Solitary benign neurilemmonma of the sciatic nerve. Clin Orthop 161: 220
Campbell R (1990) Tumours of peripheral and sympathetic nerves. In: Youmans JR (ed) Neurological surgery. Saunders, Philadelphia, pp 3667–3675
Cerofolini E, Landi A, DeSantis G (1991) MR of benign peripheral nerve sheath tumours. J Comput Assist Tomogr 15: 593–597
Cohen LM, Schwartz AM, Rockoff SD (1986) Benign schwannomas. Pathologic basis for CT inhomogeneities. AJR 147: 141–145
Cravioto H (1988) Neoplasms of peripheral nerves. In: Wilkins R, Rengachary S (eds) Neurosurgery. Williams and Wilkins, Baltimore, pp 1894–1899
Cutler EC, Gross RE (1936) Neurofibroma and neurofibrosarcoma of peripheral nerves, unassociated with Recklinghausen's disease: a report of twenty-five cases. Arch Surg 33: 733–779
Das Gupta TK (1978) Tumours of the peripheral nerves. Clin Neurosurg 25: 574–590
Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI (1969) Benign solitary schwannomas (neurilemomas). Cancer 24: 355–366
Donner RT, Voorhies RM, Kline DG (1994) Neural sheath tumours of major nerves. J Neurosurg 81: 362–373
Dubuisson A, Fissette J, Vivario M, Reznik M, Stevenaert A (1991) A benign tumour of the sciatic nerve: case report and review of the literature. Acta Neurol Belg 91: 5–11
Enneking WF (1983) Musculoskeletal tumour surgery. Churchill Livingstone, New York, pp 1271–1302
Enziger FM, Weiss SW (1983) Soft tissue tumours. CV Mosby, St Louis, pp 151–211
Erlandson RA, Woodruff JM (1982) Peripheral nerve sheath tumours: an electron microscopie study of 43 cases. Cancer 49: 273–287
Esselinckx V, Trigaux JP, Maldague B, Maldague B, Malghem J, Knoops P, Thauvoy C (1986) Sciatic neuropathy at the popliteal fossa: clinical, ultrasonographic and computed tomographic diagnosis. Clin Rheumatol 5: 107–111
Fisher RG, Tate HB (1970) Isolated neurilemomas of the brachial plexus. J. Neurosurg 32: 463–467
Horak E, Szentirmay Z, Sugar I (1983) Pathologic features of nerve sheath tumours with respect to prognostic signs. Cancer 51: 1159–1167
Hudson AR, Gentili F, Kline D (1988) Peripheral nerve tumours. In: Schmidek H, Sweet W (eds) Operative neurosurgical techniques. Indications, methods, and results. Grune and Stratton, New York, pp 1599–1618
Hughes DG, Wilson DJ (1986) Ultrasound appearances of peripheral nerve tumours. Br J Radiol 59: 1041–1043
Kline DG, Hudson AR (1995) Operative results for major nerve injuries, entrapments and tumours. Saunders, Philadelphia, pp 150–220
Kumar AJ, Kuhajda FP, Martinez CR, Fishman EK, Jezic DV, Siegelman SS (1983) Computed tomography of extracranial nerve sheath tumours with pathological correlation. J Comput Assist Tomogr 7: 857–865
Le Viet D, Lantieri L, Loy S (1993) Resectable tumours of the peripheral nerves. A propos of 73 nerve tumours in 53 patients. Ann Chir Plast Esthet 38: 172–179
Lebreton E, Merle M, Maneaud M, Foucher G, Schwartz N, Michan J (1985) Les schwannomes des nerfs peripheriques. Leurs localisations et leur traitement. Ann Chir Plast Esthet 30: 309–315
Louis D (1987) Peripheral nerve tumours of the upper extremity. Hand Clin 3: 311–318
MacKinnon SE, Dellon AL (1988) Tumours of peripheral nerve. In: MacKinnon SE, Dellon AL (eds) Surgery of the peripheral nerve. Thieme, New York, pp 535–549
Murray MR, Stout AP (1942) Demonstration of the formation of reticulin by schwannian tumour cells in vitro. Am J Pathol 18: 585–594
Phalen GS (1976) Neurilemmomas of the forearm and hand. Clin Orthop 114: 219–222
Prusick VR, Herkowitz HN, Davidson DD, Stambough JL, Rothman RH (1968) Sciatica from a sciatic neurilemmoma. J Bone Joint Surg 68: 1456–1457
Prokop A, Pichlmaier H (1993) Peripheral neurogenic tumours. Surgical therapy of nerve sheath tumours. Review and personal results. Zentralbl Chir 118: 665–675
Richardson RR, Siqueira EB, Oi S, Nunez C (1979) Neurogenic tumours of the brachial plexus: report of two cases. Neurosurgery 4: 66–70
Sala Cartero D, Leombruni E, Del Rosal C, Amillo Garayoa S (1992) Tumours of nerve sheaths of the peripheral nerves. Ann Ital Chir 63: 445–450
Schiffer D, Gaiani A (1993) Prognostic factors in peripheral nervous system tumours. Crit Rev Neurosurg 3: 313–324
Smith RJ, Lipke RW (1980) Surgical treatment of peripheral nerve tumours of the upper limb. In: Omer G, Spinner M (eds) Management of peripheral nerve tumours of the upper limb. Saunders, Philadelphia, pp 694–711
Smith W, Amis JA (1992) Neurilemoma of the tibial nerve. A case report. J Bone Joint Surg (Am) 74: 443–444
Soderlund V, Goranson H, Bauer HC (1994) Imaging of benign peripheral nerve sheath tumours. Acta Radiol 35: 282–286
Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ (1992) Peripheral (extracranial) nerve tumours: correlation of MR imaging and histologie findings. Radiology 183: 34–346
Tang J, Ishii S, Usui M, Naito T (1990) Multifocal neurilemomas in different nerves of the same upper extremity. J Hand Surg 15: 788–792
Thiebot J, Laissy JP, Delangre T, Biga N, Liotard A (1991) Benign solitary neurinomas of the sciatic popliteal nerves. CT study. Neuroradiology 33: 186–188
Thomas JE, Piepgras DG, Scheithauer B, Onofrio BM, Shives TC (1983) Neurogenic tumours of the sciatic nerve. A clinicopathologic study of 35 cases. Mayo Clin Proc 58: 640–647
Zuckerman JB, Powers B, Miller JW, Lippert F (1988) Benign solitary schwannoma of the foot. Clin Orthop 228: 278–280
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Artico, M., Cervoni, L., Wierzbicki, V. et al. Benign neural sheath tumours of major nerves: Characteristics in 119 surgical cases. Acta neurochir 139, 1108–1116 (1997). https://doi.org/10.1007/BF01410969
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DOI: https://doi.org/10.1007/BF01410969