Robotic Nerve Sheath Tumor Resection With Intraoperative Neuromonitoring: Case Series and Systematic Review

Posterior trunk defects have been a challenging anatomical area to cover in reconstructive surgery. The use of local myocutaneous flaps has been described extensively in the literature to cover these defects, but these techniques are associated with significant donor-site morbidity, including functional loss of muscle units. Freestyle perforator flaps enable local tissue recruitment with skin of a similar color and texture in diverse anatomic areas, but there is a shortage of case series on posterior trunk defects using propeller dorsal intercostal artery perforator (DICAP) flaps, particularly when the defects are extensive. In this report, the authors present a successful case of a DICAP propeller flap for an extensive defect on the upper back following a malignant peripheral nerve sheath tumor resection.

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Intraoperative Neuromonitoring in Patients with Intramedullary Spinal Cord Tumor: A Systematic Review, Meta-Analysis, and Case Series

World Neurosurgery ◽

10.1016/j.wneu.2019.01.007 ◽

2019 ◽

Vol 125 ◽

pp. 498-510.e2 ◽

Cited By ~ 3

Author(s):

Koen Rijs ◽

Markus Klimek ◽

Marjan Scheltens-de Boer ◽

Karla Biesheuvel ◽

Biswadjiet S. Harhangi

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Meta Analysis ◽

Spinal Cord Tumor ◽

Case Series ◽

Intraoperative Neuromonitoring ◽

Intramedullary Spinal Cord ◽

Intramedullary Spinal Cord Tumor

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HEMANGIOMAS OF THE BRACHIAL PLEXUS

Neurosurgery ◽

10.1227/01.neu.0000335643.41581.1d ◽

2009 ◽

Vol 65 (suppl_4) ◽

pp. A181-A188 ◽

Cited By ~ 3

Author(s):

Nathan J. Ranalli ◽

Jason H. Huang ◽

Edward B. Lee ◽

Paul J.L. Zhang ◽

Evan S. Siegelman ◽

...

Keyword(s):

Brachial Plexus ◽

Preoperative Evaluation ◽

Tumor Resection ◽

Signs And Symptoms ◽

University Teaching ◽

Pathological Examination ◽

Preoperative Embolization ◽

Brachial Plexopathy ◽

Nerve Sheath Tumor ◽

Nerve Sheath

Abstract OBJECTIVE Hemangiomas of the brachial plexus are very rare, and there has not been a collection of multiple cases published in the literature to date. Extraneural brachial plexus hemangiomas typically present with similar signs and symptoms as nerve sheath tumors, including pain, paresthesia, and occasionally weakness, in addition to nonspecific imaging findings, making their diagnosis difficult. Exploratory surgery can lead to significant bleeding and nerve injury when a hemangioma or an associated aneurysm is encountered intraoperatively. We present 5 cases of extraneural hemangiomas causing brachial plexopathy, including pre-, intra-, and postoperative decision making, with an emphasis on diagnostic and management issues as well as outcomes. METHODS A retrospective review was performed of 5 patients who underwent surgery at a university teaching hospital between 1995 and 2007 for exploration of brachial plexus lesions that were confirmed to be hemangiomas at pathological examination. RESULTS All 5 patients presented with findings on history, physical examination, imaging, and electromyography suggesting a diagnosis of nerve sheath tumor. Two patients had biopsies (1 needle, 1 open), both of which were nondiagnostic. Three patients underwent digital subtraction angiography with successful preoperative embolization. Each patient had a complete or a radical subtotal tumor resection, and all were intact neurologically after surgical resection. Pathological evaluation identified 3 venous hemangiomas, 1 hemangioma with arteriovenous malformation features, and 1 Masson hemangioma associated with a large aneurysm. CONCLUSION Extraneural hemangiomas of the brachial plexus are very rare, but a high index of suspicion and appropriate preoperative evaluation, including angiography with the option for embolization, can result in decreased intraoperative hemorrhage and better patient outcomes.

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Feline periocular peripheral nerve sheath tumor: a case series

Veterinary Ophthalmology ◽

10.1111/j.1463-5224.2005.00341.x ◽

2005 ◽

Vol 8 (3) ◽

pp. 153-158 ◽

Cited By ~ 22

Author(s):

Allison Hoffman ◽

Tiffany Blocker ◽

Richard Dubielzig ◽

E. J. Ehrhart

Keyword(s):

Peripheral Nerve ◽

Case Series ◽

Nerve Sheath Tumor ◽

Peripheral Nerve Sheath Tumor ◽

Nerve Sheath

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Giant Malignant Peripheral Nerve Sheath Tumor of the Head and Neck: A Case Report and Literature Review

Ear Nose & Throat Journal ◽

10.1177/0145561319897645 ◽

2020 ◽

pp. 014556131989764 ◽

Cited By ~ 2

Author(s):

Anju Chen ◽

Tiantian Wang ◽

Xianfa Xu

Keyword(s):

Peripheral Nerve ◽

Head And Neck ◽

Tumor Resection ◽

Muscle Flap ◽

Petrous Bone ◽

Surgical Reconstruction ◽

Temporal Region ◽

Nerve Sheath Tumor ◽

Peripheral Nerve Sheath Tumor ◽

Nerve Sheath

Malignant peripheral nerve sheath tumor (MPNST) is a malignant soft tissue sarcoma with high mortality, low morbidity, and poor prognosis. The MPNST occurs mostly in the limbs and torso, and rarely in the head and neck. However, MPNST is insensitive to radiotherapy and chemotherapy, and complete surgical resection with negative margin is the most important and effective strategy. We present a case of MPNST in the head and neck. The tumor invades the left temporal bone, petrous bone, and mastoid bone, and compression changes in the focal cerebellum and sigmoid sinus. The patient underwent the left temporal region tumor resection + surgical reconstruction with temporalis muscle flap and pectoralis major myocutaneous flap. Adjuvant radiotherapy (55 Gy) was given after surgery, and there were no local recurrence and distant metastasis after 31-month follow-up.

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Extramedullary melanotic schwannoma recurrence in the cervical vertebral arch: a case report and review of the literature

Journal of International Medical Research ◽

10.1177/0300060520947919 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052094791

Author(s):

Zongbin Hou ◽

Teng Shi ◽

Guangrun Li ◽

Lin Tian ◽

Xinna Li ◽

...

Keyword(s):

Neck Pain ◽

Upper Extremity ◽

Tumor Resection ◽

Pathological Examination ◽

Radical Excision ◽

Incomplete Resection ◽

Nerve Sheath Tumor ◽

Melanotic Schwannoma ◽

Nerve Sheath ◽

History Of

Melanotic schwannoma (MS), a slowly growing nerve sheath tumor, is not a purely benign tumor. MS accounts for less than 1% of all nerve sheath tumors. We herein describe a rare case of MS and present a literature review focusing on the treatment of this disease. Twelve years before presentation at our hospital, a 41-year-old woman was examined because of an 8-month history of neck pain and 6-month history of upper extremity numbness and weakness. She underwent surgery to remove a tumor, and the pathological examination confirmed a diagnosis of MS. Twelve years later, at 53 years of age, the patient presented to our hospital with a 2-year history of neck pain and upper extremity numbness and weakness. Posterior cervical tumor resection was performed along with posterior cervical laminectomy, decompression and intraspinal space-occupying internal fixation, and radiotherapy. MS recurrence was confirmed. No tumor recurrence or metastasis was found after 7 months of follow-up. Recurrence of MS is rare, and its diagnosis depends on pathological features. Radical excision is the primary treatment for MS. Incomplete resection of MS is a risk factor for postoperative recurrence and metastasis. Furthermore, postoperative adjuvant radiotherapy should be performed to prevent recurrence and metastasis of MS.

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Recurring Intracranial Malignant Peripheral Nerve Sheath Tumor: Case Report and Systematic Review of the Literature

Neurosurgery ◽

10.1227/neu.0b013e31820a1599 ◽

2011 ◽

Vol 68 (4) ◽

pp. E1152-E1159 ◽

Cited By ~ 8

Author(s):

Pepijn van den Munckhof ◽

Menno R. Germans ◽

Antoinette Y. N. Schouten-van Meeteren ◽

Foppe Oldenburger ◽

Dirk Troost ◽

...

Keyword(s):

Systematic Review ◽

Clinical Presentation ◽

Cranial Nerves ◽

En Bloc Resection ◽

Bloc Resection ◽

Nerve Sheath Tumor ◽

Review Of The Literature ◽

En Bloc ◽

Peripheral Nerve Sheath Tumor ◽

Nerve Sheath

Abstract BACKGROUND AND IMPORTANCE: To report the clinical presentation and management of an intracranial frontoparietal malignant peripheral nerve sheath tumor (MPNST) and its recurrence in a 6-year-old girl, along with a systematic review of the literature. CLINICAL PRESENTATION: A previously healthy 6-year-old girl presented with severe signs of increased intracranial pressure. Magnetic resonance imaging (MRI) revealed a large heterogeneously enhancing mass at the right frontoparietal convexity. The tumor was completely removed, the histological diagnosis was MPNST, and the patient underwent adjuvant radio- and chemotherapy. Fifteen months later, MRI revealed a small local recurrence. After upfront chemotherapy, the recurrence was removed in a radical, ie, true oncological, neuronavigationally guided, en bloc resection, including approximately 1 cm surrounding gray and white matter and overlying dura mater. Neuropathological examination revealed tumor-free margins. The patient again received adjuvant chemotherapy. Four years after diagnosis and 20 months after cessation of adjuvant therapy, there are no signs of tumor recurrence. The literature search resulted in 17 cases of intracranial MPNSTs not associated with cranial nerves. Despite macroscopically complete resection in many cases and adjuvant radio- and chemotherapy, overall survival was poor, with only 5 patients still alive upon publication (including the current patient). CONCLUSION: Intracranial MPNSTs not associated with cranial nerves are extremely rare and highly malignant tumors with poor overall survival, probably because of infiltrating growth into surrounding brain tissue. We therefore advocate consideration of nonconventional true oncological en bloc resection when approaching this rare tumor or its recurrence.

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