Table of Contents

Benign peripheral nerve sheath tumor

Benign peripheral nerve sheath tumors include schwannomas and neurofibromas.

The occurrence of benign peripheral nerve sheath tumors (PNSTs) is at least 85–90% of clinically symptomatic cases, and likely a larger percentage of subclinical cases 1).

In normal patients, the majority of these tumors are histologically schwannomas, with lesser percentages made up of other benign lesions such as hemangiomas, ganglion cysts, desmoids, malignant peripheral nerve sheath tumors (MPNST's), and other malignant lesions, such as lymphoma and metastases 2).

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 3) 4) 5).

Case series

Benign peripheral nerve sheath tumor case series.

1)
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.
2) , 3)
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.
4)
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.
5)
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.