TITLE:
Surgical Approaches to Large Peripheral Nerve Sheets Tumors
AUTHORS:
Hedaya M. Hendam, Hatem M. El Samouly, Hamdy M. Behairy
KEYWORDS:
Peripheral Nerve Sheet Tumors
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.8 No.1,
December
20,
2017
ABSTRACT: Peripheral nerve sheath tumors (PNSTs) are not rare
tumors. Its sound management is complete surgical excision. The aim of this
study was to describe clinical presentation, accuracy of different
investigations and ideal surgical approaches in relation to outcomes. The study
is a prospective and included 26 surgically treated large PNSTs in 22 patients
operated through different surgical approaches according to the site of the
tumors. The fellow up period was 6 - 60
months. The mean age was 41.8 years, 9 were males and 13 were females. The
common presentations were pain in 12 lesions, swelling in 8 lesions, neural
deficits in 4 lesions and positive Tinel’s test in 2 lesions. These lesions
were excised through 6 surgical approaches. Histopathological examination
showed 20 benign and 6 malignant lesions. Five cases of malignant peripheral
nerve sheet tumors (MPNSTs) had local recurrent, 4 cases had distant
metastasis, 4 cases received chemotherapy and radiotherapy, and 4 cases were
died in the postoperative fellow up period. It was concluded that surgical
approaches to the PNSTs, depends on their locations. Adequate exposure with
minimal dissection minimized the neurological deficit and decreased rate of
local recurrence.