Clinical Relevance of Pathological Grades of Malignant Peripheral Nerve Sheath Tumor: A Multi-Institution TMTS Study of 56 Cases in Northern Japan

Okada, Kyoji; Hasegawa, Tadashi; Tajino, Takahiro; Hotta, Tomomitsu; Yanagisawa, Michiro; Osanai, Toshihisa; Nishida, Jun; Seki, Kunihiko; Itoi, Eiji

doi:10.1245/s10434-006-9053-5

Cited by 44 publications

(42 citation statements)

References 14 publications

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“…3,5,6 In our series, a complete resection of gross disease was possible in 75% of patients which is comparable to rates of resection reported in other large series of patients referred for surgery. 5,6,21 The crude 5-year actuarial disease-specific mortality rates was 100% for patients with localized disease who underwent a partial resection whereas approximately 50% of completely resected patients were predicted to be alive at 5 years. In that only 8 patients were deemed as categorically unresectable in our series, it was not possible to make meaningful comparisons between this group and the group of patients who underwent incomplete resection.…”

Section: Discussionmentioning

confidence: 99%

Clinical, Pathological, and Molecular Variables Predictive of Malignant Peripheral Nerve Sheath Tumor Outcome

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Clinical, Pathological, and Molecular Variables Predictive of Malignant Peripheral Nerve Sheath Tumor Outcome

et al. 2009

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“…Numerous studies have analyzed factors having a possible influence on the clinical outcomes of patients with MPNSTs [26][27][28][29][30][31][32]. In these studies, it was described that older age, large tumor size, axial tumor site, inadequate surgery, NF-1, local recurrence, and previous radiotherapy were related to a poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Differential expression of angiogenic factors in peripheral nerve sheath tumors

Wasa

Nishida

Suzuki

et al. 2008

Clin Exp Metastasis

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It is difficult to differentiate some malignant peripheral nerve sheath tumors (MPNST) from benign peripheral nerve sheath tumors (BPNST) histologically, and to predict the clinical outcome of patients with MPNST. In this study, the expression of VEGF and MVD were evaluated immunohistochemically in 22 cases of MPNST, 14 of neurofibroma and 19 of schwannoma and correlation of the staining grade of VEGF or MVD and the various clinical factors were analyzed, and statistically evaluated. Levels of VEGF mRNA expression were also determined with real-time RT-PCR. Statistically higher positive staining for VEGF was observed in MPNST compared to neurofibroma (P=0.004) and schwannoma (P<0.001). Even low grade MPNST showed higher VEGF positive staining than neurofibroma. Moreover, high VEGF expression statistically correlated with the poor prognosis of the patients with MPNST (P=0.015). Although MVD in MPNST was significantly higher than that in neurofibroma (P=0.038) and schwannoma (P<0.001), MVD could not predict the prognosis of the patients with MPNST. Although VEGF mRNA expression tended to be higher in MPNST compared to neurofibroma, the difference was not significant. Levels of VEGF protein expression serve as a novel diagnostic and prognostic tools for peripheral nerve sheath tumors.

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“…About half will show local recurrence, and 40 % will show multifocality and/or metastasis [ 2 ]. The overall survival rate is approximately 50 % at 3 years and 43 % at 5 years [ 143 ]. Delay in diagnosis is not uncommon, especially for tumors arising in more proximal or head/neck locations.…”

Section: Treatment and Prognostic Featuresmentioning

confidence: 99%

Malignant Tumors of Peripheral Nerves

Kao

Parham

Fuller

2014

Pediatric Malignancies: Pathology and Imaging

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Malignant peripheral nerve sheath tumors (MPNST) represent a group of malignant spindle cell sarcomas with evidence of nerve sheath differentiation and/or arising from a peripheral nerve. Tumors showing origin from epineurial connective tissue or vascular structures are not considered to represent MPNST. Older/prior terminology for MPNST includes malignant neurilemmoma, malignant schwannoma, neurofi brosarcoma, and neurogenic sarcoma [ 1 ]. A number of histologic subtypes have been described. The majority are high grade aggressive sarcomas that show a strong tendency for local recurrence and metastases despite aggressive therapeutic measures [ 2 ]. Clinical Features and EpidemiologyThere is a strong association between MPNST and Neurofi bromatosis Type 1 (NF1), with 50 % of all MPNSTs arising within this patient population [ 3 ]. Approximately 10 % of individuals with NF1 will develop an MPNST over their lifetime, most of these tumors representing malignant degeneration occurring within preexisting plexiform neurofi bromas. One study of 476 NF1 patients documented a strong association between the presence of subcutaneous neurofi bromas and internal plexiform neurofi bromas, with an even stronger correlation between the presence of internal plexiform neurofi bromas and MPNST [ 4 ]. The remainder of MPNSTs will arise de novo, approximately 5-10 % representing radiation-induced sarcomas [ 1 ]. There is no particular gender predilection, and MPNSTs have been documented throughout a wide age range including children and the elderly. The majority however tend to present in adults with a median age in the mid 40s [ 5 ]. MPNSTs arising in the NF1 population tend to present up to a decade earlier, and these patients' tumors also tend to be larger [ 3 , 6 ].The majority of MPNST arise from larger peripheral nerves or within deep soft tissues, the most frequent sites including brachial plexus, sciatic, and paraspinal nerves, proximal upper and lower extremities, and buttock regions [ 5 ]. They have also been documented in a wide variety of locations throughout the body. Well over 50 cases of spinal MPNST have been reported [ 7 -13 ]. No particular spinal level is preferentially involved, and interestingly a significant proportion of spinal MPNST exhibit rhabdomyoblastic elements (Malignant Triton Tumor; see histologic description below) [ 14 -17 ]. MPNST represents one of the most aggressive tumors that may involve structures of the head and neck region [ 6 ]. It may arise from cranial nerves, particularly the vestibular [ 18 ], vagus [ 18 ], facial [ 18 , 19 ], and trigeminal [ 19 , 20 ]. Other sites include not only brachial plexus [ 21 ], but also scalp and bony structures (base of skull [ 22 -25 ], sinuses [ 26 , 27 ], and bones of the jaw) [ 28 , 29 ]

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Clinical Relevance of Pathological Grades of Malignant Peripheral Nerve Sheath Tumor: A Multi-Institution TMTS Study of 56 Cases in Northern Japan

Cited by 44 publications

References 14 publications

Clinical, Pathological, and Molecular Variables Predictive of Malignant Peripheral Nerve Sheath Tumor Outcome

Clinical, Pathological, and Molecular Variables Predictive of Malignant Peripheral Nerve Sheath Tumor Outcome

Differential expression of angiogenic factors in peripheral nerve sheath tumors

Malignant Tumors of Peripheral Nerves

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