Functional Restoration Following Resection of Malignant Peripheral Nerve Sheath Tumour of the Median Nerve: A Case Report

2020 ◽  
Vol 25 (03) ◽  
pp. 373-377
Author(s):  
Chung Ming Chan ◽  
Aymeric YT. Lim ◽  
Mark E. Puhaindran
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Index Finger ◽  
Sensory Nerve ◽  
Functional Restoration ◽  
Flexor Digitorum Profundus ◽  
Wide Resection ◽  
Abductor Pollicis Brevis ◽  
Nerve Branch ◽  
Nerve Sheath

Management of malignant peripheral nerve sheath tumours (MPNSTs) is primarily surgical, involving surgical resection with wide margins, and frequently radiation therapy. When a MPNST involves a major peripheral nerve, wide resection leads to significant distal neurologic deficits. A patient who underwent resection of a MPNST involving the median nerve above the elbow is presented. Staged tendon and nerve transfers were performed to restore sensation to the thumb and index finger, thumb opposition and flexion, finger flexion and forearm pronation. These included: 1. radial sensory nerve branches to digital nerves of thumb and index finger, 2. ulnar nerve branch of flexor carpi ulnaris to pronator teres, 3. brachioradialis to flexor pollicis longus, 4. side-to-side transfer of flexor digitorum profundus tendon of index finger to middle, ring and little fingers, 5. extensor indicis proprius to abductor pollicis brevis. The rationale, approach, and favourable results of functional reconstruction in this patient are detailed.

scholarly journals Novel Treatment of a Malignant Peripheral Nerve Sheath Tumor of the Median Nerve

2018 ◽  
Vol 6 (12) ◽  
pp. e2011
Author(s):  
Eirini Liodaki ◽  
Sandra Robiller ◽  
Eike Wenzel ◽  
Peter Mailaender ◽  
Felix Stang
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Nerve Sheath Tumor ◽  
Peripheral Nerve Sheath Tumor ◽  
Novel Treatment ◽  
Nerve Sheath

Delayed Transfer of the Extensor Carpi Radialis Brevis Branch of the Radial Nerve to the Anterior Interosseous Nerve for Restoration of Thumb and Index Finger Flexion: Case Report

2020 ◽  
Vol 81 (06) ◽  
pp. 571-574
Author(s):  
Renan Salomão ◽  
Jairo Porfírio de Oliveira ◽  
Carolina Fernandes Junger ◽  
Luiz Cezar Soares Ricardo ◽  
Carlos Roberto de Lima ◽  
...  
Keyword(s):  
Median Nerve ◽  
Radial Nerve ◽  
Spontaneous Recovery ◽  
Index Finger ◽  
Upper Extremities ◽  
Nerve Branch ◽  
Finger Flexion ◽  
Anterior Interosseous Nerve ◽  
Extensor Carpi Radialis ◽  
High Median

AbstractHigh median nerve injuries (HMNIs) are rare lesions involving the upper extremities and affect the median nerve from its origin to the emergence of the anterior interosseous nerve (AIN). Proximal reconstruction has long been considered the gold standard in treating HMNI, but thumb and index flexion and pinch and grip weakness are consistently not recovered. We report the surgical results of a patient affected by an HMNI with partial spontaneous recovery after a gunshot wound. AIN function was successfully restored in a delayed fashion by transferring the radial nerve branch to the extensor carpi radialis brevis to the AIN.

Malignant peripheral nerve sheath tumour of median nerve - an unusual presentation: a case report

2005 ◽  
Vol 28 (1) ◽  
pp. 50-52
Author(s):  
Rajive Mathew Jose ◽  
Danish Imran ◽  
Ramesh Vidyadharan ◽  
Paul K. Wright ◽  
G. S. Rao
Keyword(s):  
Case Report ◽  
Peripheral Nerve ◽  
Median Nerve ◽  
Unusual Presentation ◽  
Nerve Sheath Tumour ◽  
Nerve Sheath ◽  
Peripheral Nerve Sheath Tumour

Extended remission of a recurrent median nerve malignant peripheral nerve sheath tumor after multimodal treatment

2005 ◽  
Vol 103 (4) ◽  
pp. 760-763 ◽  
Author(s):  
Howard Landy ◽  
Lynn Feun ◽  
Arnold Markoe ◽  
Sherri Patchen ◽  
Joy Bruce ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Postoperative Radiotherapy ◽  
Nerve Sheath Tumor ◽  
Total Removal ◽  
Content Type ◽  
Fractionated Radiotherapy ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Additional Surgery

✓ Malignant peripheral nerve sheath tumors (MPNSTs) are difficult to control despite aggressive treatment. In this report the authors describe the treatment and follow-up review of a patient with neurofibromatosis Type 1 who harbored a recurrent median nerve MPNST. The man underwent preoperative intraarterial and intravenous chemotherapy followed by additional surgery for gross-total removal and postoperative radiotherapy. Two courses of preoperative intraarterial cisplatin and intravenous Adriamycin produced significant tumor shrinkage. Gross-total removal of the remaining tumor without amputation of the arm was followed by fractionated radiotherapy (total minimum tumor dose 6485 cGy, maximal dose 6575 cGy). The patient is alive 9.5 years after treatment without evidence of tumor recurrence and with only focal median nerve functional deficits. A review of the patient's treatment is warranted to provide a description of a regimen that may be useful in the treatment of similar patients in the future.

Inflammatory pseudotumor of the median nerve

2001 ◽  
Vol 95 (1) ◽  
pp. 124-128 ◽  
Author(s):  
Carlos Pérez-López ◽  
Manuel Gutiérrez ◽  
Alberto Isla
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Inflammatory Pseudotumor ◽  
Mononuclear Cells ◽  
Histological Study ◽  
Systemic Disease ◽  
Nerve Sheath Tumor ◽  
Content Type ◽  
Peripheral Nerve Sheath Tumors ◽  
Nerve Sheath

✓ The authors report the presence of an inflammatory pseudotumor of the median nerve in a young woman who presented with a sensorimotor deficit in the median nerve area. Magnetic resonance (MR) images revealed a fusiform mass in the nerve, and the patient underwent surgery for a suspected peripheral nerve—sheath tumor. Her clinical condition improved slowly and notably. Histological study revealed a heterogeneous lymphoid infiltration with mononuclear cells, lymphocytes (mostly T cells), and plasmocytoid cells. Because of the unknown significance of this infiltration, the patient was examined to exclude the possible diagnosis of a systemic tumoral process. All the studies yielded negative results and no systemic disease was found. Later, control MR imaging revealed no tumoral remains, and electromyography demonstrated progressive improvement of median nerve function. The follow-up period has been 8 years. The cause of the lesion is unknown. The differential diagnosis includes benign and malignant peripheral nerve—sheath tumors, lymphoma, and all tumorlike lesions of peripheral nerves.

Median Nerve Compression, with Tendon Ruptures, after Colles’ Fracture

1984 ◽  
Vol 9 (2) ◽  
pp. 139-141 ◽  
Author(s):  
F. Y. H. WONG ◽  
R. W. H. PHO
Keyword(s):  
Median Nerve ◽  
Index Finger ◽  
Corrective Osteotomy ◽  
Tendon Repair ◽  
Flexor Digitorum Profundus ◽  
Flexor Pollicis Longus ◽  
Colles Fracture ◽  
Tendon Ruptures ◽  
Flexor Pollicis Longus Tendon ◽  
Flexor Digitorum

A rare case of rupture of the flexor pollicis longus tendon following a Colles’ fracture is described. The patient also had a ruptured flexor digitorum profundus to the index finger and compression of the median nerve of the same hand. The ruptures were noted after four weeks of plaster immobilisation. Decompression of the median nerve and corrective osteotomy was performed but no tendon repair was attempted. The patient regained good function of the hand.

Interfascicular Grafts of Non-Nerve Tissues for Gaps in Peripheral Nerve Trunks

1996 ◽  
Vol 21 (6) ◽  
pp. 830-831
Author(s):  
J.B. Tang ◽  
D. Shi ◽  
Y-Q. Gu
Keyword(s):  
Peripheral Nerve ◽  
Median Nerve ◽  
Ulnar Nerve ◽  
Treatment Option ◽  
Alternative Treatment ◽  
Vein Graft ◽  
Sensory Nerve ◽  
Clinical Results ◽  
Nerve Injuries ◽  
Alternative Treatment Option

Ten cases with gaps in nerve trunks in the forearm were treated by interfascicular grafts of autogenous veins. These included three cases of median nerve injuries, five cases of ulnar nerve injuries and two cases of radial sensory nerve injuries. The nerve gaps ranged from 1.5 to 4.5 cm with an average of 3 cm. Completely divided nerve trunks were repaired by two or three vein conduits. For incomplete nerve injuries or replacement of a single fasciculus, a single vein conduit was used. For nerve defects over 3 cm, normal nerve tissues were sectioned from the proximal nerve fasciculus and inserted into the vein conduits. These cases were followed for 2 years and 2 months to 3 years. The results were M3 in two, M4 in six and S2 + in two, S3 + in seven and S4 in one nerves. This study suggests that interfascucular grafts of vein conduits can be applied in patients with nerve gaps shorter than 4.5 cm and with favourable wound conditions with fairly good clinical results. Interfascicular vein graft provides an alternative treatment option for gaps in distal peripheral nerve trunks.

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