Acta Neurochirurgica

, Volume 139, Issue 12, pp 1108–1116 | Cite as

Benign neural sheath tumours of major nerves: Characteristics in 119 surgical cases

  • M. Artico
  • L. Cervoni
  • V. Wierzbicki
  • V. D'Andrea
  • F. Nucci
Clinical Articles


Peripheral benign nerve sheath tumours are infrequent tumours and affect major nerve trunks. Some authors have indicated a high and prohibitive incidence of neurological injury in resection of these lesions. The authors describe their findings in a retrospective study comprising 119 patients with spontaneous benign nerve sheath tumours of the peripheral nervous system. Seventy-three patients had a schwannoma, 41 had neurofibroma and 5 had plexiform neurofibroma; 25 of the 119 patients suffered from neurofibromatosis. All schwannomas were excised completely and the outcome of patients was 41.0% improved, 6.8% worsened, 52.0% unchanged. Twenty-eight neurofibromas were excised completely and 13 subtotally; the outcome for patients was 19.5% improved, 19.5% worsened and 61% unchanged. All plexiform neurofibromas were removed subtotally and the outcome for patients was 20% improved and 80% unchanged. The best surgical results at average follow-up of 6 years were observed in the patients with schwannoma, the worst in those with plexiform neurofibroma. Our results demonstrated that it is often possible to remove schwannomas as well as neurofibromas with an acceptable risk of injury to the nerve.


Schwannoma neurofibroma neurofibromatosis peripheral nerve tumour 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ariel IM (1980) Current concepts in the management of peripheral nerve tumours. In: Omer G, Spinner M (eds) Management of peripheral nerve lesions. Saunders, Philadelphia, pp 669–693Google Scholar
  2. 2.
    Ariel IM (1988) Tumours of peripheral nervous system. Semin Surg Oncol 4: 7–12PubMedGoogle Scholar
  3. 3.
    Barre PS, Shaffer JW, Cart JR, Lacey SH (1987) Multiplicity of neurilemomas in the upper extremity. J Hand Surg 12: 307–311Google Scholar
  4. 4.
    Brooks D (1984) Clinical presentation and treatment of peripheral nerve tumours. In: Dyck P, Lambert E, Thomas P (eds) Peripheral neuropathy. Saunders, Philadelphia, pp 2236–2251Google Scholar
  5. 5.
    Byrne JJ, Cahill JM (1961) Tumours of major peripheral nerves. Am J Surg 102: 724–727PubMedGoogle Scholar
  6. 6.
    Burger PC, Vogel FS, Scheithauer BW (1982) Surgical pathology of the nervous system and its coverings. Wiley, New York, pp 649–669Google Scholar
  7. 7.
    Biga N, Thomine JM, Deshayes P (1987) Difficulties encountered in diagnosing benign solitary neurilemmoma of the popliteal region. Rev Rheum 54: 435–436.Google Scholar
  8. 8.
    Butt M, Annan JH (1981) Solitary benign neurilemmonma of the sciatic nerve. Clin Orthop 161: 220PubMedGoogle Scholar
  9. 9.
    Campbell R (1990) Tumours of peripheral and sympathetic nerves. In: Youmans JR (ed) Neurological surgery. Saunders, Philadelphia, pp 3667–3675Google Scholar
  10. 10.
    Cerofolini E, Landi A, DeSantis G (1991) MR of benign peripheral nerve sheath tumours. J Comput Assist Tomogr 15: 593–597PubMedGoogle Scholar
  11. 11.
    Cohen LM, Schwartz AM, Rockoff SD (1986) Benign schwannomas. Pathologic basis for CT inhomogeneities. AJR 147: 141–145PubMedGoogle Scholar
  12. 12.
    Cravioto H (1988) Neoplasms of peripheral nerves. In: Wilkins R, Rengachary S (eds) Neurosurgery. Williams and Wilkins, Baltimore, pp 1894–1899Google Scholar
  13. 13.
    Cutler EC, Gross RE (1936) Neurofibroma and neurofibrosarcoma of peripheral nerves, unassociated with Recklinghausen's disease: a report of twenty-five cases. Arch Surg 33: 733–779Google Scholar
  14. 14.
    Das Gupta TK (1978) Tumours of the peripheral nerves. Clin Neurosurg 25: 574–590PubMedGoogle Scholar
  15. 15.
    Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI (1969) Benign solitary schwannomas (neurilemomas). Cancer 24: 355–366PubMedGoogle Scholar
  16. 16.
    Donner RT, Voorhies RM, Kline DG (1994) Neural sheath tumours of major nerves. J Neurosurg 81: 362–373PubMedGoogle Scholar
  17. 17.
    Dubuisson A, Fissette J, Vivario M, Reznik M, Stevenaert A (1991) A benign tumour of the sciatic nerve: case report and review of the literature. Acta Neurol Belg 91: 5–11PubMedGoogle Scholar
  18. 18.
    Enneking WF (1983) Musculoskeletal tumour surgery. Churchill Livingstone, New York, pp 1271–1302Google Scholar
  19. 19.
    Enziger FM, Weiss SW (1983) Soft tissue tumours. CV Mosby, St Louis, pp 151–211Google Scholar
  20. 20.
    Erlandson RA, Woodruff JM (1982) Peripheral nerve sheath tumours: an electron microscopie study of 43 cases. Cancer 49: 273–287PubMedGoogle Scholar
  21. 21.
    Esselinckx V, Trigaux JP, Maldague B, Maldague B, Malghem J, Knoops P, Thauvoy C (1986) Sciatic neuropathy at the popliteal fossa: clinical, ultrasonographic and computed tomographic diagnosis. Clin Rheumatol 5: 107–111PubMedGoogle Scholar
  22. 22.
    Fisher RG, Tate HB (1970) Isolated neurilemomas of the brachial plexus. J. Neurosurg 32: 463–467PubMedGoogle Scholar
  23. 23.
    Horak E, Szentirmay Z, Sugar I (1983) Pathologic features of nerve sheath tumours with respect to prognostic signs. Cancer 51: 1159–1167PubMedGoogle Scholar
  24. 24.
    Hudson AR, Gentili F, Kline D (1988) Peripheral nerve tumours. In: Schmidek H, Sweet W (eds) Operative neurosurgical techniques. Indications, methods, and results. Grune and Stratton, New York, pp 1599–1618Google Scholar
  25. 25.
    Hughes DG, Wilson DJ (1986) Ultrasound appearances of peripheral nerve tumours. Br J Radiol 59: 1041–1043PubMedGoogle Scholar
  26. 26.
    Kline DG, Hudson AR (1995) Operative results for major nerve injuries, entrapments and tumours. Saunders, Philadelphia, pp 150–220Google Scholar
  27. 27.
    Kumar AJ, Kuhajda FP, Martinez CR, Fishman EK, Jezic DV, Siegelman SS (1983) Computed tomography of extracranial nerve sheath tumours with pathological correlation. J Comput Assist Tomogr 7: 857–865PubMedGoogle Scholar
  28. 28.
    Le Viet D, Lantieri L, Loy S (1993) Resectable tumours of the peripheral nerves. A propos of 73 nerve tumours in 53 patients. Ann Chir Plast Esthet 38: 172–179PubMedGoogle Scholar
  29. 29.
    Lebreton E, Merle M, Maneaud M, Foucher G, Schwartz N, Michan J (1985) Les schwannomes des nerfs peripheriques. Leurs localisations et leur traitement. Ann Chir Plast Esthet 30: 309–315PubMedGoogle Scholar
  30. 30.
    Louis D (1987) Peripheral nerve tumours of the upper extremity. Hand Clin 3: 311–318PubMedGoogle Scholar
  31. 31.
    MacKinnon SE, Dellon AL (1988) Tumours of peripheral nerve. In: MacKinnon SE, Dellon AL (eds) Surgery of the peripheral nerve. Thieme, New York, pp 535–549Google Scholar
  32. 32.
    Murray MR, Stout AP (1942) Demonstration of the formation of reticulin by schwannian tumour cells in vitro. Am J Pathol 18: 585–594Google Scholar
  33. 33.
    Phalen GS (1976) Neurilemmomas of the forearm and hand. Clin Orthop 114: 219–222PubMedGoogle Scholar
  34. 34.
    Prusick VR, Herkowitz HN, Davidson DD, Stambough JL, Rothman RH (1968) Sciatica from a sciatic neurilemmoma. J Bone Joint Surg 68: 1456–1457Google Scholar
  35. 35.
    Prokop A, Pichlmaier H (1993) Peripheral neurogenic tumours. Surgical therapy of nerve sheath tumours. Review and personal results. Zentralbl Chir 118: 665–675PubMedGoogle Scholar
  36. 36.
    Richardson RR, Siqueira EB, Oi S, Nunez C (1979) Neurogenic tumours of the brachial plexus: report of two cases. Neurosurgery 4: 66–70PubMedGoogle Scholar
  37. 37.
    Sala Cartero D, Leombruni E, Del Rosal C, Amillo Garayoa S (1992) Tumours of nerve sheaths of the peripheral nerves. Ann Ital Chir 63: 445–450PubMedGoogle Scholar
  38. 38.
    Schiffer D, Gaiani A (1993) Prognostic factors in peripheral nervous system tumours. Crit Rev Neurosurg 3: 313–324Google Scholar
  39. 39.
    Smith RJ, Lipke RW (1980) Surgical treatment of peripheral nerve tumours of the upper limb. In: Omer G, Spinner M (eds) Management of peripheral nerve tumours of the upper limb. Saunders, Philadelphia, pp 694–711Google Scholar
  40. 40.
    Smith W, Amis JA (1992) Neurilemoma of the tibial nerve. A case report. J Bone Joint Surg (Am) 74: 443–444Google Scholar
  41. 41.
    Soderlund V, Goranson H, Bauer HC (1994) Imaging of benign peripheral nerve sheath tumours. Acta Radiol 35: 282–286PubMedGoogle Scholar
  42. 42.
    Suh JS, Abenoza P, Galloway HR, Everson LI, Griffiths HJ (1992) Peripheral (extracranial) nerve tumours: correlation of MR imaging and histologie findings. Radiology 183: 34–346Google Scholar
  43. 43.
    Tang J, Ishii S, Usui M, Naito T (1990) Multifocal neurilemomas in different nerves of the same upper extremity. J Hand Surg 15: 788–792Google Scholar
  44. 44.
    Thiebot J, Laissy JP, Delangre T, Biga N, Liotard A (1991) Benign solitary neurinomas of the sciatic popliteal nerves. CT study. Neuroradiology 33: 186–188PubMedGoogle Scholar
  45. 45.
    Thomas JE, Piepgras DG, Scheithauer B, Onofrio BM, Shives TC (1983) Neurogenic tumours of the sciatic nerve. A clinicopathologic study of 35 cases. Mayo Clin Proc 58: 640–647PubMedGoogle Scholar
  46. 46.
    Zuckerman JB, Powers B, Miller JW, Lippert F (1988) Benign solitary schwannoma of the foot. Clin Orthop 228: 278–280PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1997

Authors and Affiliations

  • M. Artico
    • 1
  • L. Cervoni
    • 2
  • V. Wierzbicki
    • 3
  • V. D'Andrea
    • 4
  • F. Nucci
    • 5
  1. 1.Chair of Human Anatomy, Faculty of Pharmacy“La Sapienza” University of RomeRomeItaly
  2. 2.Department of Neurosurgery, Neurological Mediterranean “Neuromed” InstituteIRCCs, Pozzilli (Is)RomeItaly
  3. 3.Military Policlinic of RomeRomeItaly
  4. 4.III Surgical Clinic “La Sapienza” University of RomeRomeItaly
  5. 5.Department of Neurological Sciences, II Chair of Neurosurgery“La Sapienza” University of RomeRomeItaly

Personalised recommendations