TY - JOUR
T1 - Multinodular/plexiform (multifascicular) schwannomas of major peripheral nerves
T2 - An underrecognized part of the spectrum of schwannomas - Clinical article
AU - Hébert-Blouin, Marie Noëlle
AU - Amrami, Kimberly K.
AU - Scheithauer, Bernd W.
AU - Spinner, Robert J.
PY - 2010/2
Y1 - 2010/2
N2 - Object. In clinical practice, schwannomas are among the most common types of nerve sheath tumors. Their clinical presentation, imaging characteristics, and operative features are well known. Over the past 20 years, clinical outcomes have improved due to resection of these tumors at a fascicular level. Despite these advances, a subgroup of patients with schwannomas is associated with a disappointing neurological outcome following resection. The purpose of this study was to correlate the imaging and histological features in this group of patients with more anatomically complex forms of schwannomas. Methods. In a retrospective review performed at their institution over a 10-year period, the authors found a subgroup of patients with complex multinodular/plexiform schwannomas affecting major peripheral nerves. Eleven patients were identified, and the clinical, imaging, and pathological features of their disease were reviewed. Results. The clinical presentation of multinodular/plexiform schwannomas of major peripheral nerves may be similar to that of conventional schwannomas, but their imaging features, operative appearance, and outcomes differ. Conclusions. Preoperatively and intraoperatively, the distinguishing features of multinodular/plexiform schwannomas of major peripheral nerves may be subtle and can easily go unrecognized, thus explaining the often suboptimal surgical results. Familiarity with the imaging and operative features of multinodular/plexiform schwannomas will no doubt alter treatment approaches and improve neurological function in this subgroup of patients.
AB - Object. In clinical practice, schwannomas are among the most common types of nerve sheath tumors. Their clinical presentation, imaging characteristics, and operative features are well known. Over the past 20 years, clinical outcomes have improved due to resection of these tumors at a fascicular level. Despite these advances, a subgroup of patients with schwannomas is associated with a disappointing neurological outcome following resection. The purpose of this study was to correlate the imaging and histological features in this group of patients with more anatomically complex forms of schwannomas. Methods. In a retrospective review performed at their institution over a 10-year period, the authors found a subgroup of patients with complex multinodular/plexiform schwannomas affecting major peripheral nerves. Eleven patients were identified, and the clinical, imaging, and pathological features of their disease were reviewed. Results. The clinical presentation of multinodular/plexiform schwannomas of major peripheral nerves may be similar to that of conventional schwannomas, but their imaging features, operative appearance, and outcomes differ. Conclusions. Preoperatively and intraoperatively, the distinguishing features of multinodular/plexiform schwannomas of major peripheral nerves may be subtle and can easily go unrecognized, thus explaining the often suboptimal surgical results. Familiarity with the imaging and operative features of multinodular/plexiform schwannomas will no doubt alter treatment approaches and improve neurological function in this subgroup of patients.
KW - Clinical outcome
KW - Nerve
KW - Nerve sheath tumor
KW - Plexiform schwannoma
KW - Schwannoma
KW - Surgical outcome
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U2 - 10.3171/2009.5.JNS09244
DO - 10.3171/2009.5.JNS09244
M3 - Article
C2 - 19499977
AN - SCOPUS:76149131332
SN - 0022-3085
VL - 112
SP - 372
EP - 382
JO - Journal of neurosurgery
JF - Journal of neurosurgery
IS - 2
ER -