Management of benign nerve sheath tumors of the brachial plexus: relevant diagnostic and surgical features. About a series of 17 patients (19 tumors) and review of the literature

Dubuisson, Annie; Reuter, Gilles; Kaschten, Bruno; Martin, Didier; Racaru, Tudor; Steinmetz, Maximilien; Gérardy, François

doi:10.1007/s13760-020-01560-7

Cited by 6 publications

(9 citation statements)

References 28 publications

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“…Out of the remaining 26 studies, four articles from the Louisiana State University Health Sciences Center were excluded due to cohort duplication 19 – 21 or a lack of qualitative data 22 . Ultimately, a total of 22 articles were included in the qualitative synthesis of this systematic review 1 – 3 , 12 – 14 , 23 – 38 .…”

Section: Resultsmentioning

confidence: 99%

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Patient demographics, tumor characteristics, and outcomes following surgical treatment of benign and malignant brachial plexus tumors: a systematic review

Shekouhi

Chim

2023

International Journal of Surgery

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Background: Various treatment options have been introduced for the management of primary tumors of the brachial plexus (BP), ranging from conservative therapy to wide local excision with/without postoperative chemoradiotherapy. However, no consensus exists regarding optimal treatment strategies based on collated and published data. Objective: The aim of this study was to investigate the clinicopathological characteristics and outcome of patients with primary tumors of the BP who underwent surgical treatment. Data sources: A systematic search of the four main online databases, including Web of Science (WOS), PubMed, Scopus, and Google Scholar, was conducted. Study selection: All related articles addressing the clinical outcome and role of surgical interventions for management of primary tumors of the BP. Intervention: Optimal surgical and radiotherapeutic interventions for benign and malignant lesions based on the pathologic characteristics and location of primary BP tumors. Results: A total of 687 patients (693 tumors) with a mean age of 41.7±8.7 years old were evaluated. In total, 629 (90.8%) tumors were benign, and 64 (9.2%) were malignant, with a mean tumor size of 5.4±3.1 cm. The location of the tumor was reported for 639 patients. For these tumors, 444 (69.5%) originated from the supraclavicular region, and 195 (30.5%) were infraclavicular. The trunks were the most common location for tumor involvement, followed by the roots, cords, and terminal branches. Gross total resection was achieved in 432 patients and subtotal resection (STR) was performed in 109 patients. With neurofibromas, STR still resulted in good outcomes. The outcomes following treatment of malignant peripheral nerve sheath tumors were poor regardless of the type of resection. In general, symptoms related to pain and sensory issues resolved rapidly postoperatively. However, the resolution of motor deficits was often incomplete. Local tumor recurrence occurred in 15 (2.2%), patients and distant metastasis was observed in only eight (1.2%) cases. The overall mortality was 21 (3.1%) patients among the study population. Limitations: The main limitation was the lack of level I and II evidence. Conclusions: The ideal management strategy for primary BP tumors is complete surgical resection. However, in some cases, particularly for neurofibromas, STR may be preferable to preserve maximal neurological function. The degree of surgical excision (total or subtotal) mainly depends on the pathological characteristics and primary location of the tumor.

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Section: Resultsmentioning

confidence: 99%

“…One of the potential difficulties concerning optimal management of BP tumors relates to the risk of preoperative biopsy due to the proximity of the lesions to or involvement of adjacent nerves, which can lead to neurological deficits 12 . Thus, the pathologic characteristics of the tumor are not commonly available prior to surgery.…”

Section: Introductionmentioning

confidence: 99%

Patient demographics, tumor characteristics, and outcomes following surgical treatment of benign and malignant brachial plexus tumors: a systematic review

Shekouhi

Chim

2023

International Journal of Surgery

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“…It has an incidence of 0.3–04/100.000 cases per year [ 12 ]. There are 72 previous reported cases of lower limb sciatic nerve schwannoma that we identified from the literature review from the past 51 years until December 2020 [ 1 , 3 , 4 , 5 , 6 , 8 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ].…”

Section: Discussionmentioning

confidence: 99%

Schwannoma of the Sciatic Nerve as a Cause of Extra-articular Knee Pain: Case Report and Literature Review

Nkosi,

Chauke

2023

jocr

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Introduction: Schwannomas are rare benign tumors of the nerve sheath that originate from the Schwann cells of the peripheral nerve and have a broad anatomic distribution that includes superficial tissues, deep tissues, including the central nervous system, and the gastrointestinal system. Case Report: A 60-year-old male presented with left knee pain for 5 years. This pain was associated with paresthesia, night pain unresponsive to analgesia, on the left foot intermittent pins and needles sensation. Schwannoma lesion was excised, histology confirmed the diagnosis, and the patient’s symptoms improved. Conclusion: Schwannoma around the knee is a rare or atypical cause of the non-arthritic pain and should be considered in the differential diagnosis of non-arthritic and extra-articular causes of knee pain with neurological deficit of the foot in an adult population. Keywords: Schwannoma, sciatic nerve, knee pain, benign tumor.

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“…The “rat tail sign,” which is specific for neurogenic tumors, is easier to be found on imaging. Meanwhile, current imaging studies of neurofibromas are mainly focused on deep neurofibromas 3,4 . Localized cutaneous neurofibromas affect small nerves and manifest as nodular lesions.…”

Section: Introductionmentioning

confidence: 99%

Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

Shen,

Wang,

Zhao

et al. 2024

J of Clinical Ultrasound

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ObjectiveTo describe the ultrasound characteristics of nodular localized cutaneous neurofibroma (NLCN).Materials and MethodsClinical features and ultrasound characteristics of 43 lesions of 40 patients pathologically proven as NLCNs at Peking University Shenzhen Hospital from October 2014 to May 2022 were analyzed retrospectively. The location, length‐to‐thickness (L/T) ratio, thickness‐to‐width (T/W) ratio, shape, margin, capsule, echogenicity, echotexture, posterior features, vascularity, and “rat tail sign” were evaluated.ResultsAll ultrasound findings showed almost perfect agreement. More than a half of NLCNs (n = 24, 55.8%, p < 0.001) were located in the subcutaneous fat layer wholly with well‐demarcation from dermis and deep fascia. Most of the NLCNs were fusiform shape (n = 27, 62.8%, p < 0.001) in the long axis and oval shape (n = 35, 81.4%, p < 0.001) in the short axis. The other ultrasound findings of NLCNs included well‐defined (n = 42, 97.7%, p < 0.001), encapsulated (n = 39, 90.7%, p < 0.001), predominately hypoechoic (n = 34, 79.1%, p < 0.001), homogeneous (n = 39, 90.7%, p < 0.001), posterior enhancement (n = 29, 67.4%, p = 0.033), and avascularity (n = 37, 86.0%, p < 0.001). Only a quarter (n = 11, 25.6%, p = 0.002) of lesions were recognized with the “rat tail sign.”ConclusionNLCNs present as fusiform shape in long axis and round shape in short axis. The common ultrasound findings of NLCNs are well‐defined, encapsulated, predominately hypoechoic, homogeneous lesion with posterior enhancement, and poor blood supply. The “rat tail sign” has low sensitivity in NLCNs.

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Management of benign nerve sheath tumors of the brachial plexus: relevant diagnostic and surgical features. About a series of 17 patients (19 tumors) and review of the literature

Cited by 6 publications

References 28 publications

Patient demographics, tumor characteristics, and outcomes following surgical treatment of benign and malignant brachial plexus tumors: a systematic review

Patient demographics, tumor characteristics, and outcomes following surgical treatment of benign and malignant brachial plexus tumors: a systematic review

Schwannoma of the Sciatic Nerve as a Cause of Extra-articular Knee Pain: Case Report and Literature Review

Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

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