A precise excision technique for schwannomas

Hussain, Muhammad Ali; Jhattu, Hardeep; Pandya, Atisha A; Chan, Queenie; Pandya, Wg Cdr Ankur

doi:10.1007/s00238-012-0715-1

Cited by 6 publications

(7 citation statements)

References 16 publications

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“…Extracapsular excision is an operative technique commonly used for removal of schwannomas. 4,14,20 To reduce the risk of damage to nerve fascicles during dissection of a tumour, different authors suggest modifications of the operative technique. Hussain et al, propose "tumour release by incising the capsule far lateral to the path of the nerve and dissecting the tumour circumferentially from its capsule.…”

Section: Discussionmentioning

confidence: 99%

“…The epineural capsule is then left behind and acts as a protective covering of the nerve." 20 The intracapsular technique was used by Date et al 21 The above authors have compared results obtained after extracapsular and intracapsular enucleation of schwannoma and have found the latter technique to be superior due to lower risk of complications. 21 In case of presence of adhesions between epineurium and the capsule, Date and co-workers performed microenucleation of the tumour (tumour was resected piece-by-piece).…”

Section: Discussionmentioning

confidence: 99%

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Analysis of surgical outcome and review of literature of schwannomas arising from the extremities

et al. 2019

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Background: Schwannoma is a benign peripheral nerve sheath tumour derived from Schwann cells. Also known as Neurilemoma, it can affect any nerve in the body. They usually present as a painless swelling or paresthesia over the sensory distribution of the affected nerve. Although it is classically described that schwannomas are well encapsulated and can be completely enucleated during excision, many of them have fascicular involvement and could not be completely shelled out. The aim of this work is to present our experience in operative management of schwannomas located in extremities.Methods: Authors conducted a retrospective review for 18 adult patients with schwannoma, from June 2012 to June 2018. There were 10 men and 8 women, ranging from 20 to 68 years of age, with a mean age of 46 years old. All patients had excision done for the tumour and histopathological examination confirmed schwannoma. All patients were preoperatively evaluated both clinically and radiologically. FNAC was also done to confirm the origin of the swelling.Results: The mean follow up period has been 2 years. Complete excision with preservation of nerve was done in all cases except for one case in which nerve graft was used.Conclusions: Use of preoperative MRI, magnification and good surgical technique will help to enucleate the tumour completely without any collateral damage or recurrence. The possibility and option of nerve graft should be discussed with patients prior to schwannoma excision, so that nerve grafting could be directly proceeded with patient consent in case there is fascicular involvement of tumour found intraoperatively.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Analysis of surgical outcome and review of literature of schwannomas arising from the extremities

et al. 2019

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“…Extracapsular excision is an operative technique commonly used for removal of schwannomas [ 11 , 12 , 38 , 48 ]. To reduce the risk of damage to nerve fascicles during dissection of a tumour, different authors suggest modifications of the operative technique.…”

Section: Discussionmentioning

confidence: 99%

“…Hussain et al propose “tumour release by incising the capsule far lateral to the path of the nerve and dissecting the tumour circumferentially from its capsule. The epineural capsule is then left behind and acts as a protective covering of the nerve” [ 48 ]. The intracapsular technique was used by Date et al [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

“…The above authors have compared results obtained after extracapsular and intracapsular enucleation of schwannoma and have found the latter technique to be superior due to lower risk of complications [ 38 ]. In case of presence of adhesions between epineurium and the capsule, Date and co-workers performed microenucleation of the tumour (“tumour was resected piece-by-piece”), unlike Hussain et al who removed the tumour in one piece [ 38 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

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Results of Surgical Treatment of Schwannomas Arising from Extremities

Gosk

Gutkowska

Urban

et al. 2015

BioMed Research International

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Schwannomas are benign neoplasms derived from Schwann cells. In this work, we present our experience in operative management of schwannomas and analyse results of treatment. Clinical material consisted of 34 patients, in whom 44 schwannomas located in extremities were excised between 1985 and 2013. Thirty-five tumours originated from major peripheral nerves and 9 from small nerve branches. Postoperatively, in the first group of tumours, pain resolved in 100%, paresthesias in 83.3%, and Hoffmann-Tinel sign in 91.6% of the patients. Improvement in motor function was noted in 28.5% of the cases, in sensory function: complete in 70%, and partial in 15%. The most frequently affected major peripheral nerves were the ulnar (11 tumours) and median (5 tumours) nerves. Schwannomas originating from small nerve branches were removed without identification of the site of origin. After their resection, definitive healing was achieved. Conclusions. (1) Schwannomas located in extremities arise predominantly from major peripheral nerves, most commonly the ulnar and median nerves. (2) Gradual tumour growth causes exacerbation of compression neuropathy, creating an indication for surgery. (3) In most cases, improvement in peripheral nerve function after excision of schwannoma is achieved. (4) The risk of new permanent postoperative neurological deficits is low.

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Apresentação rara de schwannoma no tornozelo: Um relato de caso

Gupta

Acharya

Panda

2020

Rev Bras Ortop (Sao Paulo)

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ResumoSchwannomas são tumores benignos de crescimento lento, e constituem 8% de todos os tumores de tecido mole. Os sinais clínicos e sintomas são muitas vezes mal interpretados por causa da baixa incidência, e, muitas vezes, esses tumores são mal diagnosticados. Um paciente do sexo masculino de 39 anos apresentou um inchaço solitário não traumático sobre o aspecto posteromedial do tornozelo direito, que aumentou gradualmente de tamanho e estava associado a dor. O inchaço era clinicamente firme, não flutuante, e não associado a qualquer comprometimento sensório-motor. A excisão cirúrgica do inchaço foi feita sem danificar os vasos e os nervos circundantes. O exame histopatológico do tumor excisado revelou schwannoma.

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A precise excision technique for schwannomas

Cited by 6 publications

References 16 publications

Analysis of surgical outcome and review of literature of schwannomas arising from the extremities

Analysis of surgical outcome and review of literature of schwannomas arising from the extremities

Results of Surgical Treatment of Schwannomas Arising from Extremities

Apresentação rara de schwannoma no tornozelo: Um relato de caso

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