Log in

Surgical treatment of typical peripheral schwannomas: the risk of new postoperative deficits

  • Clinical Article - Neurosurgical Techniques
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

Although peripheral schwannomas can be resected without postoperative neurological complications, surgeons must anticipate the possibility that new neurological deficits could develop. In order to evaluate the risk of neurological complications in the surgical treatment of these tumours, we performed a retrospective review of cases involving schwannomas in the extremities, as well as an analysis of the related literature.

Method

We reviewed a combined series of 72 schwannomas from the extremities presenting for surgical excision. Meticulous analysis of the files was undertaken, searching for pre-operative findings that could be more frequent in patients with surgical complications. The incidence, severity, and transitory nature of post-operative complications in our series was observed and compared against the literature.

Results

Eleven patients (15.2 %) developed new neurological deficits after surgery: sensory disturbance in seven cases, motor weakness in three, and a single wound hematoma. Most of these complications were temporary. Statistical analysis demonstrated a positive relationship between the presence of complications and both patient age under 50 years (p = 0.02) and tumours greater than 3 cm in greatest diameter (p = 0.02).

Conclusions

Although relatively infrequent, the potential for novel post-operative deficits after the surgical treatment of peripheral schwannomas does exist and should be included during pre-operative counseling.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Spain)

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ariel IM (1980) Current concepts in the management of peripheral nerve tumors. In: Omer G, Spinner M (eds) Management of peripheral nerve lesions. WB Saunders, Philadelphia, pp 669–693

    Google Scholar 

  2. Artico M, Cervoni L, Wiwezbicki V, D’Andrea V, Nucci F (1997) Benign neural sheath tumours of major nerves: characteristics in 119 surgical cases. Acta Neurochir 139(12):1108–1116

    Article  PubMed  CAS  Google Scholar 

  3. Brooks D (1984) Clinical presentation and treatment of peripheral nerve tumors. In: Dyck P, Lambert E, Thomas P (eds) Peripheral neuropathy. WB Saunders Philadelphia, Philadelphia, pp 2236–2251

    Google Scholar 

  4. Campbell R (1990) Tumors of peripheral and sympathetic nerves. In: Youmans JR (ed) Neurological surgery. WB Saunders Philadelphia, Philadelphia, pp 3667–3675

    Google Scholar 

  5. Cerofolini E, Landi A, DeSantis G (1991) MR of benign peripheral nerve sheath tumors. J Comput Assist Tomogr 15(4):593–597

    Article  PubMed  CAS  Google Scholar 

  6. Cravioto H (1988) Neoplasms of peripheral nerves. In: Wilkins R, Rengachary S (eds) Neurosurgery. Williams and Wilkins, Baltimore, pp 1894–1899

    Google Scholar 

  7. Das Gupta TK (1978) Tumors of the peripheral nerves. Clin Neurosurg 25:574–590

    PubMed  CAS  Google Scholar 

  8. Date R, Muramatsu K, Ihara K, Taguchi T (2012) Advantages of intra-capsular micro-enucleation of schwannoma arising from extremities. Acta Neurochir 154(1):173–178

    Article  PubMed  CAS  Google Scholar 

  9. Donner RT, Voorhies RM, Kline DG (1994) Neural sheath tumors of major nerves. J Neurosurg 81(3):362–373

    Article  PubMed  CAS  Google Scholar 

  10. Ganju A, Roosen N, Kline DG, Tiel RL (2001) Outcomes in a consecutive series of 111 surgically treated plexal tumors: a review of the experience at the Louisiana State University Health Sciences Center. J Neurosurg 95(1):51–60

    Article  PubMed  CAS  Google Scholar 

  11. Giannini C (2005) Tumors and tumor-like conditions of peripheral nerves. In: Dyck PJ, Thomas PK (eds) Peripheral neuropathy, 4th edn. Elsevier Saunders, Philadelphia, pp 2585–2606

    Chapter  Google Scholar 

  12. Kang HJ, Shin SJ, Kang ES (2000) Schwannomas of the upper extremity. J Hand Surg Br 25(6):604–607

    Article  PubMed  CAS  Google Scholar 

  13. Kehoe NJS, Reid RP, Semple JC (1995) Solitary benign peripheral nerve tumours: review of 32 years experience. J Bone Joint Surg Br 77(3):497–500

    PubMed  CAS  Google Scholar 

  14. Kim SM, Seo SW, Lee JY (2012) Surgical outcome of Schwannomas arising from major peripheral nerves in the lower limb. Int Orth 36(8):1721–1725

    Article  Google Scholar 

  15. Knight DMA, Birch R, Pringle J (2007) Benign solitary schwannomas. J Bone Joint Surg Br 89(3):382–387

    PubMed  CAS  Google Scholar 

  16. Levi AD, Ross AL, Cuartas E, Qadir R, Temple HT (2010) The surgical management of symptomatic peripheral nerve sheath tumors. Neurosurgery 66(4):833–840

    Article  PubMed  Google Scholar 

  17. Maniker AH (2004) Diagnostic steps, imaging, and electrophysiology. Neurosurg Clin N Am 15:133–144

    Article  PubMed  Google Scholar 

  18. Oberle J, Kahamba J, Richter HP (1997) Peripheral nerve schwannomas – an analysis of 16 patients. Acta Neurochir 139(10):949–953

    Article  PubMed  CAS  Google Scholar 

  19. Ogose A, Hotta T, Morita T, Yamamura S, Hosaka N, Kobayashi H, Hirata Y (1999) Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis. Skeletal Radiol 28(4):183–188

    Article  PubMed  CAS  Google Scholar 

  20. Park MJ, Seo KN, Kang HJ (2009) Neurological deficit after surgical enucleation of schwannomas of the upper limb. J Bone Joint Surg Br 91(11):1482–1486

    PubMed  CAS  Google Scholar 

  21. Resnick JM, Fanning CV, Caraway NP, Varma DG, Johnson M (1997) Percutaneous needle biopsy diagnosis of benign neurogenic neoplasms. Diagn Cytopathol 16(1):17–25

    Article  PubMed  CAS  Google Scholar 

  22. Rinaldi E (1983) Neurilemomas and neurofibromas of the upper limb. J Hand Surg Am 8(5):590–593

    Article  PubMed  CAS  Google Scholar 

  23. Sawada T, Sano M, Ogihara H, Omura T, Miura K, Nagano A (2006) The relationship between pre-operative symptoms, operative findings and postoperative complications in schwannomas. J Hand Surg Br 31(6):629–634

    Article  PubMed  CAS  Google Scholar 

  24. Siqueira MG, Martins RS, Teixeira MJ (2009) Management of brachial plexus region tumours and tumour-like conditions: relevant diagnostic and surgical features in a consecutive series of eighteen patients. Acta Neurochir 151(9):1089–1098

    Article  PubMed  CAS  Google Scholar 

  25. Soderlund V, Göranson H, Bauer HC (1994) Imaging of benign peripheral nerve sheath tumors. Acta Radiol 35(3):282–286

    PubMed  CAS  Google Scholar 

  26. Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ (1992) Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings. Radiology 183(2):341–346

    PubMed  CAS  Google Scholar 

  27. Weiss SW, Goldblum JR, Enzinger FM (2001) Benign tumours of the peripheral nerves. In: Weiss SW, Goldblum JR (eds) Enzinger and Weiss’s soft tissue tumors, 4th edn. Mosby, St Louis, pp 1111–1208

    Google Scholar 

  28. Woodruff JM, Selig AM, Crowley K, Allen PW (1994) Schwannoma (neurilemoma) with malignant transformation: a rare distinctive peripheral nerve tumor. Am J Surg Pathol 18(9):882–895

    Article  PubMed  CAS  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mario G. Siqueira.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Siqueira, M.G., Socolovsky, M., Martins, R.S. et al. Surgical treatment of typical peripheral schwannomas: the risk of new postoperative deficits. Acta Neurochir 155, 1745–1749 (2013). https://doi.org/10.1007/s00701-013-1818-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-013-1818-6

Keywords

Navigation