Primary Brachial Plexus Tumors: Clinical Experiences of 143 Cases

Clin Neurol Neurosurg. 2016 Sep:148:91-5. doi: 10.1016/j.clineuro.2016.07.009. Epub 2016 Jul 4.

Abstract

Objective: Primary brachial plexus tumors are extremely rare and the treatment is challengeable. Our aim is to share the experiences in the treatment of primary brachial plexus tumors.

Methods: A retrospective analysis of 143 patients with primary brachial plexus tumors was made in our department from January 2001 to December 2012. The clinical presentation of the patients, the characteristics and pathological results of the tumors and the prognosis were described.

Results: Seventy-eight males and sixty-five female were enrolled. The mean age was 48.17 years old. A palpable mass was the most common clinical presentation occurred in 129 patients. The trunks of the brachial plexus were the locations where the tumors originated with high possibility, with 68 cases. Benign tumors were composed of 119 schwannomas and 12 neurofibromas, while malignant tumors were composed of 8 malignant peripheral nerve sheath tumors, 2 malignant granular cell tumors, 1 synovial sarcoma and 1 peripheral primitive neuroectodermal tumor. Appropriate surgical method, radiotherapy and chemotherapy were used according to the condition during operation, preoperative examinations and pathological result. The survival rate was 50.00% with a 3-year follow-up. Local recurrence happened in 7 patients. Five patients presented Metastasis.

Conclusions: Appropriate surgical method is the key for the treatment of different brachial plexus tumors. Surgery has a great effect on the treatment of benign tumors. For malignant tumors, adjuvant radiotherapy or chemotherapy should be used according to the pathological result. The general prognosis for malignant brachial plexus tumors is less than ideal.

Keywords: malignant granular cell tumor; malignant peripheral nerve sheath tumor; neurofibroma; peripheral primitive neuroectodermal tumor; primary brachial plexus tumor; schwannoma; synovial sarcoma.

MeSH terms

  • Adult
  • Brachial Plexus / diagnostic imaging
  • Brachial Plexus / pathology*
  • Brachial Plexus / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peripheral Nervous System Neoplasms / diagnostic imaging
  • Peripheral Nervous System Neoplasms / pathology*
  • Peripheral Nervous System Neoplasms / surgery*
  • Prognosis
  • Retrospective Studies
  • Treatment Outcome