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Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves

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Abstract

Peripheral nerve sheath tumors comprise a significant percentage of both benign and malignant soft tissue tumors. The vast majority of these lesions are schwannomas and neurofibromas, which most radiologists are familiar with including the well-described multimodality imaging features. However, numerous additional often under-recognized benign entities associated with nerves exist. These rarer entities are becoming increasingly encountered with the proliferation of cross-sectional imaging, particularly magnetic resonance imaging (MRI). It is important for the radiologist to have a basic understanding of these entities as many have near-pathognomonic MR imaging features as well as specific clinical presentations that when interpreted in concert, often allows for a limited differential or single best diagnosis. The ability to provide a prospective, pre-intervention diagnosis based solely on imaging and clinical presentation is crucial as several of these entities are “do not touch” lesions, for which even a biopsy may have deleterious consequences. To our knowledge, the majority of these benign entities associated with nerves have only been described in scattered case reports or small case series. Therefore, the aim of this article is to provide a radiopathologic comprehensive review of these benign entities that arise in association with nerves with a focus on characteristic MRI features, unique histopathologic findings, and entity specific clinical exam findings/presentation.

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Acknowledgements

Tori Seasor, MD; Contributor, Department of Pathology, University of Utah

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Authors and Affiliations

  1. Department of Diagnostic Radiology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, Portland, OR, 97239, USA

    Marco G. Aru, Raluca McCallum & Barry G. Hansford

  2. Department of Pathology, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd, L-471, Portland, OR, 97239, USA

    Jessica L. Davis & Eric C. Nomura

  3. Department of Diagnostic Radiology, University of Chicago, 5841 South Maryland Avenue, MC2026, Chicago, IL, 60637, USA

    Gregory S. Stacy

  4. Department of Radiology and Imaging Sciences, University of Utah, 30 N 1900 E, Rm #1A71, Salt Lake City, UT, 84132, USA

    Megan K. Mills

  5. Department of Diagnostic Radiology, University of Michigan Health System, 1500 E. Medical Center Dr, TC2910Q, Ann Arbor, MI, 48109, USA

    Corrie M. Yablon

  6. Department of Diagnostic Radiology, University of Utah School of Medicine, Intermountain Healthcare, Salt Lake City, UT, 84132, USA

    Christopher J. Hanrahan

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  1. Marco G. Aru
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Aru, M.G., Davis, J.L., Stacy, G.S. et al. Beyond schwannomas and neurofibromas: a radiological and histopathological review of lesser-known benign lesions that arise in association with peripheral nerves. Skeletal Radiol 52, 649–669 (2023). https://doi.org/10.1007/s00256-022-04207-1

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