Surgical treatment of typical peripheral schwannomas: the risk of new postoperative deficits

Abstract

Although relatively infrequent, the potential for novel post-operative deficits after the surgical treatment of peripheral schwannomas does exist and should be included during pre-operative counseling.

Schwannoma of the medial cutaneous nerve of the arm: a rare location with concomitant compression neuropathy of the ulnar nerve

“…Firstly, this location of schwannoma is extremely rare in clinical practice. In the upper limb, these tumours are most commonly located in the ulnar, median and radial nerves, being significantly rarer in the musculocutaneous and axillary nerves [1,3,5,6,18]. In our For this reason, dysfunction of the medial cutaneous nerve of the arm does not cause evident discomfort in patients, in contrast to impairment of function of other nerves [2,16,20].…”

“…Levi et al observed new, postoperative neurological deficits in 41% of their patients who had previously been subjected to such procedures (biopsy or operation) at the surgical site [12]. It is also important to be aware that the results obtained after biopsy are not always identical to the results of histopathological examination of the surgically removed tumour [1,[17][18][19]. It has been suggested that biopsy is recommended in case of a suspected malignant lesion [3,14].…”

“…However, biopsy of a nerve tumour is connected with the risk of certain complications. The possibility of haemorrhage and damage to viable fascicles has been highlighted [3,11,18]. It may lead to secondary intraneural scarring and aggravation of neuropathic pain [3,10,11].…”

“…It has been suggested that biopsy is recommended in case of a suspected malignant lesion [3,14]. At the same time, the possibility of spread of malignant neoplastic cells as a result of tumour biopsy has been emphasised [7,18].…”

Endoscopic Excision of Schwannoma of Sciatic Nerve Using Hip Arthroscopy

“…new neurological deficits could develop. 8) In the majority of cases, even when the tumor is carefully dissected from the involved nerve, incomplete nerve palsies sometimes occur. Levi et al 9) reported an 25.3% incidence of postoperative neurologic deficits in patients who had previously undergone schwannoma excision.…”