A 10-Year Review of Benign and Malignant Peripheral Nerve Sheath Tumors in a Single Center: Clinical and Radiographic Features Can Help to Differentiate Benign from Malignant Lesions

Furniss, Dominic; Swan, Marc C.; Morritt, Daniel G.; Lim, Joanna; Khanna, Tarun; Way, Benjamin; Athanasou, Nick; Giele, Henk; Critchley, Paul

doi:10.1097/01.prs.0000297636.93164.cb

Cited by 44 publications

(28 citation statements)

References 10 publications

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“…Benign tumors are difficult to distinguish from malignant PNSTs both clinically and radiologically (Furniss et al, 2008). Malignant PNST tend to be larger (>5 cm), and may exhibit ill-defined margins suggesting infiltration of adjacent tissues and associated edema (Stull et al, 1991;Li et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

Adductor magnus: A post‐operative illustration of its dual nerve supply

Barrett¹,

Arthurs²

2009

Clinical Anatomy

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We present a case in which MRI clearly demonstrated the function of the sciatic nerve by highlighting the complications of its involvement by disease and subsequent surgery. In this clinical case, the underlying diagnosis of a nerve sheath tumour had been established and treated surgically, and subsequent follow-up imaging confirmed the expected features of sciatic nerve transection. Six months following the removal of the tumour, atrophy was seen in the muscle groups supplied by the branches of this nerve. This was manifested as muscle wasting and high signal on T1 and T2-weighted MRI affecting the biceps femoris (short and long heads), semimembranosus, semitendinosus, and the hamstring (ischiocondylar) part of the adductor magnus, but the adductor part of the adductor magnus, supplied by the obturator nerve, was spared and appeared normal.

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Section: Discussionmentioning

confidence: 99%

Adductor magnus: A post‐operative illustration of its dual nerve supply

Barrett¹,

Arthurs²

2009

Clinical Anatomy

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“…5 An elevated risk for malignancy occurs when tumors suddenly change in size, appear locally invasive, become painful, or have a brief duration of symptoms. 17,[25][26][27] The sensitivity of MRI for diagnosing malignant PNSTs was reported as 79%. 27 Malignancy can occur de novo or from previously benign nerve cells and is suspected when the tumor exhibits an irregular shape, unclear or invasive margins, presence of intratumoral lobulation, high signal-intensity area on T1-weighted imaging, or an inhomogeneous contrast enhancement.…”

Section: Malignant Tumorsmentioning

confidence: 98%

“…17,[25][26][27] The sensitivity of MRI for diagnosing malignant PNSTs was reported as 79%. 27 Malignancy can occur de novo or from previously benign nerve cells and is suspected when the tumor exhibits an irregular shape, unclear or invasive margins, presence of intratumoral lobulation, high signal-intensity area on T1-weighted imaging, or an inhomogeneous contrast enhancement. 26,28,29 When managing a likely malignant tumor, biopsy is required to make a diagnosis.…”

Section: Malignant Tumorsmentioning

confidence: 98%

Nerve Tumors

Clarke

Kaufmann

2010

The Journal of Hand Surgery

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“…6 However, the different features between MPNST and benign schwannoma within the skull and spinal canal still need further investigation.…”

Section: Clinical and Radiological Differential Diagnoses For Intracrmentioning

confidence: 99%

Clinical, radiological, and pathological features of 26 intracranial and intraspinal malignant peripheral nerve sheath tumors

Ren

Wang

et al. 2013

JNS

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Object Intracranial and intraspinal malignant peripheral nerve sheath tumors (MPNSTs) are rarely reported because of their extremely low incidence. Knowledge about these tumors is poor. In this study the authors aimed to analyze the incidence and clinical, radiological, and pathological features of intracranial and intraspinal MPNSTs. Methods Among 4000 cases of intracranial and intraspinal PNSTs surgically treated between 2004 and 2011 at Beijing Tiantan Hospital, cases of MPNST were chosen for analysis and were retrospectively reviewed. To determine which parameters were associated with longer progression-free survival (PFS) and overall survival (OS), statistical analysis was performed. Results Malignant PNSTs accounted for 0.65% of the entire series of intracranial and intraspinal PNSTs. Twenty-four (92.3%) of these 26 MPNSTs were primary. Radiologically, 26.9% (7 of 26) of the MPNSTs were misdiagnosed as nonschwannoma diseases. Twenty-one patients were followed up for 1.5 to 102 months after surgery. Twelve patients experienced tumor recurrence, and median PFS was 15.0 months. The 2- and 3-year PFS rates were 47.7% and 32.7%, respectively. Five patients died of tumor recurrence, and median OS was not available. The 2- and 3-year OS rates were 74.7% and 64.0%, respectively. Univariate analysis revealed that female sex, total tumor removal, and primary MPNSTs were significantly associated with a better prognosis. Multivariate analysis revealed that only total removal was an independent prognostic factor for both PFS and OS. Conclusions Malignant PNST within the skull or spinal canal is a rare neoplasm and is seldom caused by benign schwannomas. Radiologically, intracranial or intraspinal MPNST should be differentiated from meningioma, chordoma, fibrous dysplasia of bone, and ear cancer. Total resection whenever possible is necessary for the prolonged survival of patients, especially males.

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A 10-Year Review of Benign and Malignant Peripheral Nerve Sheath Tumors in a Single Center: Clinical and Radiographic Features Can Help to Differentiate Benign from Malignant Lesions

Abstract: The authors have reviewed their institutional experience of peripheral nerve sheath tumors over a 10-year period. Their results will help to focus clinical and radiologic investigation of patients presenting with these tumors.

Cited by 44 publications

References 10 publications

Adductor magnus: A post‐operative illustration of its dual nerve supply

Adductor magnus: A post‐operative illustration of its dual nerve supply

Nerve Tumors

Clinical, radiological, and pathological features of 26 intracranial and intraspinal malignant peripheral nerve sheath tumors

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