Benign peripheral nerve sheath tumor [Neurosurgery Wiki]

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====== Benign peripheral nerve sheath tumor ======

Benign [[peripheral nerve sheath tumor]]s include schwannomas and neurofibromas.

The occurrence of benign [[peripheral nerve sheath tumor]]s (PNSTs) is at least 85–90% of clinically symptomatic cases, and likely a larger percentage of subclinical cases
((Ogose A, Hotta T, Morita T, Yamamura S, Hosaka N, Kobayashi H, Hirata Y. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skeletal radiology. 1999;3(4):183–188. doi: 10.1007/s002560050498.)).

In normal patients, the majority of these tumors are histologically [[schwannoma]]s, with lesser percentages made up of other benign lesions such as [[hemangioma]]s, [[ganglion cyst]]s, desmoids, [[malignant peripheral nerve sheath tumor]]s (MPNST's), and other malignant lesions, such as [[lymphoma]] and [[metastases]]
((Kim DH, Murovic JA, Tiel RL, Kline DG. Operative outcomes of 546 Louisiana State University Health Sciences Center peripheral nerve tumors. Neurosurgery clinics of North America. 2004;3(2):177–192. doi: 10.1016/j.nec.2004.02.006.)).

===== Differential diagnosis =====

Of clear importance is the ability to differentiate between benign and [[malignant peripheral nerve sheath tumor]] as early as possible in the clinical work-up and management of these lesions, as they are treated very differently, and exhibit very different clinical and intraoperative behaviors. Ideally, the probable diagnosis should be known prior to surgery, as malignant tumors are more likely to require aggressive resection and possibly amputation in order to achieve any degree of oncologic control of these aggressive tumors.

===== Treatment =====

[[Benign peripheral nerve sheath tumor treatment]].

===== Outcome =====

Benign lesions, in contrast, are often able to be easily resected away from nerve fibers with minimum morbidity 
((Kim DH, Murovic JA, Tiel RL, Kline DG. Operative outcomes of 546 Louisiana State University Health Sciences Center peripheral nerve tumors. Neurosurgery clinics of North America. 2004;3(2):177–192. doi: 10.1016/j.nec.2004.02.006.))
((Kim DH, Murovic JA, Tiel RL, Kline DG. Management and outcomes in 318 operative common peroneal nerve lesions at the Louisiana State University Health Sciences Center. Neurosurgery. 2004;3(6):1421–8; discussion 1428-9. doi: 10.1227/01.NEU.0000124752.40412.03.))
((Fein DA, Lee WR, Lanciano RM, Corn BW, Herbert SH, Hanlon AL, Hoffman JP, Eisenberg BL, Coia LR. Management of extremity soft tissue sarcomas with limb-sparing surgery and postoperative irradiation: do total dose, overall treatment time, and the surgery-radiotherapy interval impact on local control? International journal of radiation oncology, biology, physics. 1995;3(4):969–976.)).


===== Case series =====

[[Benign peripheral nerve sheath tumor case series]].