Peripheral nerve tumors in adults and children: clinical and diagnostic characteristics
https://doi.org/10.17650/1683-3295-2023-25-3-69-77
Abstract
Aim. To describe clinical and instrumental characteristics of patients with primary solitary and multiple tumors of the peripheral nerves.
Materials and methods. Data from 45 patients were analyzed. In accordance with the examination results, the patients were retrospectively divided into 2 groups: 1) with solitary tumors: schwannomas (n = 22), neurofibromas (n = 10), perineuriomas (n = 5), neurofibrosarcomas (n = 2); 2) with multiple tumors: schwannomatosis (n = 3) and neurofibromatosis (n = 3).
Results. The study did not show differences in the severity of motor deficit and the results of neurophysiological exams between solitary and multiple tumors; however, differences between pathomorphological types were observed. The most benign disease course was observed in patients with schwannomas, including multiple schwannomas; severe motor deficit was observed in patients with neurofibrosarcomas and crossover neurofibromas. Pain component was characteristic of neurofibrosarcomas, neurofibromas and melanotic schwannoma; perineuriomas were characterized by painless progression.
Conclusion. Compulsory scan along the nerve allows to find tumors in clinically intact areas and other nerves.
About the Authors
D. S. Druzhinin
Yaroslavl State Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
Dmitry Sergeevich Druzhinin
The Department of Nervous Diseases with Medical Genetics and Neurosurgery
6 Revolutsionnaya St., Yaroslavl 150006
A. S. Karapetyan
S.S. Yudin City Clinical Hospital, Moscow Healthcare Department
Russian Federation
Russian Federation
4 Kolomenskiy proezd, Moscow 115446
M. L. Novikov
Medical center “Motus”
Russian Federation
Russian Federation
93 Tutaevskoe Shosse, Yaroslavl 150033
E. S. Druzhinina
N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation
Russian Federation
1 Ostrovityanova St., Moscow 117997
References
1. Yusupova D.G., Suponeva N.A., Zimin A.A. et al. Validation of the Leeds Assessment of Neuropathic Symptoms and Signs Pain Scale (LANSS) in Russia. Nervno-mishenye bolezny = Neuromuscular Diseases 2018;8(3):43–50. (In Russ.). DOI: 10.17650/2222-8721-2018-8-3-43-50
2. Naumova E.S., Nikitin S.S., Druzhinin D.S. Quantitative sonographic characteristics of the peripheral nerves in healthy individuals. Annaly klinicheskoy i experimentalnoy nevrologii = Annals of Clinical and Experimental Neurology 2017;11(1):55–61. (In Russ.). DOI: 10.18454/ACEN.2017.1.6162
3. Zhou H.Y., Jiang S., Ma F.X., Lu H. Peripheral nerve tumors of the hand: clinical features, diagnosis, and treatment. World J Clin Cases 2020;8(21):5086–98. DOI: 10.12998/wjcc.v8.i21.5086
4. Louis D.N., Ohgaki H., Wiestler O.D. et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007;114(2):97–109. DOI: 10.1007/s00401-007-0243-4
5. World Health Organisation classification of tumours. Pathology and genetics of head and neck tumours. Ed. by L. Barnes, J.W. Eveson, P. Reichart, D. Sidransky. Lyon: IARC, 2005.
6. Pathology and genetics of skin tumours. In: World Health Organization classification of tumours. Ed. by P.E. Le Boit, G. Burg, D. Weedon, A. Sarasain. Lyon: IARC Press, 2006. Pp. 9–10.
7. WHO classification of tumours of soft tissue and bone. Ed. by C.D. Fletcher, J.A. Bridge, P.C. Hongendroorn, F. Mertens. Lyon: IARC, 2013. Pp. 10–11.
8. Gabhane S.K., Kotwal M.N., Bobhate S.K. Morphological spectrum of peripheral nerve sheath tumors: a series of 126 cases. Indian J Pathol Microbiol 2009;52(1):29–33. DOI: 10.4103/0377-4929.44958
9. Rodriguez F.J., Folpe A.L., Giannini C., Perry A. Pathology of peripheral nerve sheath tumors: diagnostic overview and update on selected diagnostic problems. Acta Neuropathol 2012;123(3):295–319. DOI: 10.1007/s00401-012-0954-z
10. Schaefer I.M., Fletcher C.D., Hornick J.L. Loss of H3K27 trimethylation distinguishes malignant peripheral nerve sheath tumors from histologic mimics. Mod Pathol 2016;29(1):4–13. DOI: 10.1038/modpathol.2015.134
11. Wang T., Yin H., Han S. et al. Malignant peripheral nerve sheath tumor (MPNST) in the spine: a retrospective analysis of clinical and molecular prognostic factors. J Neurooncol 2015;22(2): 349–55. DOI: 10.1007/s11060-015-1721-5
12. Shimada S., Tsuzuki T., Kuroda M. et al. Nestin expression as a new marker in malignant peripheral nerve sheath tumors. Pathol Int 2007;57(2):60–7. DOI: 10.1111/j.1440-1827.2006.02059.x
13. Ducatman B.S., Scheithauer B.W., Piepgras D.G. et al. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases. Cancer 1986;57(10):2006–21. DOI: 10.1002/1097-0142(19860515)57:10<2006::aidcncr2820571022>3.0.co;2-6
14. Kar M., Deo S.V., Shukla N.K. et al. Malignant peripheral nerve sheath tumors (MPNST) – clinicopathological study and treatment outcome of twenty-four cases. World J Surg Oncol 2006;4:55. DOI: 10.1186/1477-7819-4-55
15. Harun A., Agrawal Y., Tan M. et al. Sex and age associations with vestibular schwannoma size and presenting symptoms. Otol Neurotol 2012;33(9):1604–10. DOI: 10.1097/MAO.0b013e31826dba9e
16. Akambi Sanoussi K., Dubert T. [Schwannomas of the peripheral nerve in the hand and the upper limb: analysis of 14 cases (In French)]. Chir Main 2006;25(3–4):131–5. DOI: 10.1016/j.main.2006.06.001
17. Alkhaili J., Cambon-Binder A., Belkheyar Z. Intraneural perineurioma: a retrospective study of 19 patients. Pan Afr Med J 2018;30:275. DOI: 10.11604/pamj.2018.30.275.16072
18. Ogose A., Hotta T., Morita T. et al. Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skeletal Radiol 1999;28(4):183–8. DOI: 10.1007/s002560050498
19. Baser M.E., Friedman J.M., Evans D.G.R. Increasing the specificity of diagnostic criteria for schwannomatosis. Neurology 2006;66(05):730–2. DOI: 10.1212/01.wnl.0000201190.89751.41
20. Erlandson R.A., Woodruff J.M. Peripheral nerve sheath tumors: an electron microscopic study of 43 cases. Cancer 1982;49(2):273–87. DOI: 10.1002/1097-0142(19820115)49:2<273::aidcncr2820490213>3.0.co;2-r
21. Waggoner D.J., Towbin J., Gottesman G., Gutmann D.H. Clinicbased study of plexiform neurofibromas in neurofibromatosis 1. Am J Med Genet 2000;92(2):132–5. PMID: 10797438.
22. Pérez-Jacoiste Asín M.A., Fernández-Ruiz M., Pérez Barrios A., Prieto S. [Metastatic neurofibrosarcoma (In Spanish)]. Med Clin (Barc) 2012;138(7):e13. DOI: 10.1016/j.medcli.2011.04.027
23. Noble F., Kornberg A.J., Elder J.E., Delatycki M.B. Retrospective analysis of patients attending a neurofibromatosis type 1 clinic. J Paediatr Child Health 2007;43(1–2):55–9. DOI: 10.1111/j.1440-1754.2007.01003.x
24. Storm F.K., Eilber F.R., Mirra J., Morton D.L. Neurofibrosarcoma. Cancer 1980;45(1):126–9. DOI: 10.1002/1097-0142(19800101)45:1<126::aidcncr2820450122>3.0.co;2-u
25. Druzhinin D.S., Druzhinina E.S., Novikov M.L. et al. Informative value of ultrasound in the diagnosis of intraneural perineurio. Zhurnal Voprosy Neirokhirurgii im. N.N. Burdenko = Burdenko’s Journal of Neurosurgery 2020;84(5):72–80. (In Russ.). DOI: 10.17116/neiro20208405172
26. Kim H.J., Yang I., Jung A.Y. et al. Ultrasound and MR findings in sclerosing perineurioma. Skeletal Radiol 2011;40(3):353–5. DOI: 10.1007/s00256-010-1053-7
27. Ryu J.A., Lee S.H., Cha E.Y. et al. Sonographic differentiation between schwannomas and neurofibromas in the musculoskeletal system. J Ultrasound Med 2015;34(12):2253–60. DOI: 10.7863/ultra.15.01067
28. Beekman R., Slooff W.B., Van Oosterhout M.F. et al. Bilateral intraneural perineurioma presenting as ulnar neuropathy at the elbow. Muscle Nerve 2004;30(2):239–43. DOI: 10.1002/mus.20052
29. Wang L.M., Zhong Y.F., Zheng D.F. et al. Intraneural perineurioma affecting multiple nerves: a case report and literature review. Int J Clin Exp Pathol 2014;7(6):3347–54. PMID: 25031759
Review
For citations:
Druzhinin D.S., Karapetyan A.S., Novikov M.L., Druzhinina E.S. Peripheral nerve tumors in adults and children: clinical and diagnostic characteristics. Russian journal of neurosurgery. 2023;25(3):69-77. (In Russ.) https://doi.org/10.17650/1683-3295-2023-25-3-69-77
Views:
468
Email this article 