Arm malignant peripheral nerve sheath tumour: a rare clinical presentation

Abstract

Soft tissue sarcomas account for about 1% of malignant tumours. More than 50 subtypes of these tumours have been described with some being extremely rare, namely malignant peripheral nerve sheath tumours (MPNST). The authors present a case of a man aged 81 years with a medical history of an adenocarcinoma of the rectum, which was referred to our clinic due to a growing painless mass on the right arm. An MRI showed a well-delimited encapsulated mass involving the long head of the biceps muscle. Biopsy findings revealed a spindle cell tumour with cytonuclear pleomorphism. The patient underwent wide tumour excision and was successfully reconstructed with a latissimus dorsi functional muscle transfer. The presence of two pulmonary nodules on CT scan staging implied a lung biopsy that showed rectum primary tumour metastases. With these additional findings, the pathology department reassessed the case and reclassified the arm tumour as an MPNST, synchronous with pulmonary adenocarcinoma metastases of the rectum.

Functional Muscle Transfer after Oncologic Extremity Resection

“…The included articles were published from 1993 to 2021 and were categorized as level 4 or 5 according to OCEBM. 4 5 6 7 8 9 10 11 12 13 14 15 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43…”

“…Considering these criteria, the LD, vastus lateralis, gracilis, TFL, rectus femoris, and rectus abdominis are each considered appropriate donor muscles for FMT. In our systematic review, the LD was the most commonly used donor muscle, employed in more than half of reported cases to reconstruct defects in the anterior 10 33 35 41 43 and posterior 33 arm, deltoid, 7 34 shoulder, 4 7 and scapular region. 38 Terzis and Kostopoulos 46 reported that the LD achieved greater muscle power than did the rectus femoris and gracilis.…”

“…The included articles were published from 1993 to 2021 and were categorized as level 4 or 5 according to the Oxford Centre for Evidence-Based Medicine (OCEBM). [4][5][6][7][8][9][10][11][12][13][14][15][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43]…”