Benign solitary schwannomas: a review of 234 cases

J Bone Joint Surg Br. 2007 Mar;89(3):382-7. doi: 10.1302/0301-620X.89B3.18123.

Abstract

We reviewed 234 benign solitary schwannomas treated between 1984 and 2004. The mean age of the patients was 45.2 years (11 to 82). There were 170 tumours (73%) in the upper limb, of which 94 (40%) arose from the brachial plexus or other nerves within the posterior triangle of the neck. Six (2.6%) were located within muscle or bone. Four patients (1.7%) presented with tetraparesis due to an intraspinal extension. There were 198 primary referrals (19 of whom had a needle biopsy in the referring unit) and in these patients the tumour was excised. After having surgery or an open biopsy at another hospital, a further 36 patients were seen because of increased neurological deficit, pain or incomplete excision. In these, a nerve repair was performed in 18 and treatment for pain or paralysis was offered to another 14. A tender mass was found in 194 (98%) of the primary referrals. A Tinel-like sign was recorded in 155 (81%). Persistent spontaneous pain occurred in 60 (31%) of the 194 with tender mass, impairment of cutaneous sensibility in 39 (20%), and muscle weakness in 24 (12%). After apparently adequate excision, two tumours recurred. No case of malignant transformation was seen.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Bone Neoplasms / pathology
  • Bone Neoplasms / physiopathology
  • Bone Neoplasms / surgery
  • Brachial Plexus Neuropathies / pathology
  • Brachial Plexus Neuropathies / physiopathology
  • Brachial Plexus Neuropathies / surgery
  • Child
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Neoplasms / pathology
  • Muscle Neoplasms / physiopathology
  • Muscle Neoplasms / surgery
  • Neurilemmoma / pathology
  • Neurilemmoma / physiopathology
  • Neurilemmoma / surgery*
  • Pain / physiopathology
  • Peripheral Nervous System Neoplasms / pathology
  • Peripheral Nervous System Neoplasms / physiopathology
  • Peripheral Nervous System Neoplasms / surgery*
  • Postoperative Complications
  • Treatment Outcome