•  
  •  
 

Corresponding Author

Hesham ElSobky, MD.

Subject Area

Oncology, Peripheral nerves

Article Type

Original Study

Abstract

Background Data: Peripheral nerve sheath tumors include a wide variety of pathologies; the most common types are schwannoma and neurofibroma. The comparative and analytic studies between them regarding clinical presentation, preoperative imaging, operative management, and postoperative follow-up are scarce.

Purpose: This study aims to provide a comparative analytic study of schwannoma, neurofibroma, and their mimics.

Study Design: This is a cross-sectional analytic study.

Patients and Methods: A total of 42 tumors in 36 patients have been excised by the same operator. The demographic data, primary signs, and symptoms have been analyzed. Pre- and postoperative clinical examination and follow-up clinical examination six months after surgery were our checkpoints. MRI was our main tool of investigation to determine the size, borders, extensions, and nature of the tumor.

Results: There was a statistical significance (p = 0.001) between schwannoma, neurofibroma, and tumor mimics regarding the tumor capsule appearance in MRI with positive capsule in 100%, 0%, and 44.4% in schwannoma, neurofibroma, and tumor mimics, respectively. Furthermore, there was a statistical difference between the three pathological groups regarding the tumor margins. Intraoperatively, the capsule was assessed and showed a statistical significance (p = 0.001) with percentages of tumors with a capsule of 100%, 0%, and 55.6% in schwannoma, neurofibroma, and tumor mimics, respectively. In the follow-up period after three months, no deficit was observed in 95.7%, 50%, 77.8%, mild deficit in 4.3%, 40%, and 22.2%, and improved deficit in 0%, 10%, and 0% in schwannoma, neurofibroma, and tumor mimics, respectively. However, there was no statistical significance (p = 0.06) between the three pathological groups.

Conclusion: Management of peripheral nerve sheath tumors is still a surgical dilemma, especially the plexiform type, which needs a multidisciplinary approach. Treating a single PNST differs from treating a syndromic patient with multiple lesions.

Keywords

peripheral nerve sheath tumors, nerve tumors, schwannoma, neurofibroma, tumor mimics

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.