Abstract
The study involved 27 lateral cervical schwannomas surgically treated in the last 40 years utilizing either partial or total resection. The study aims to compare the results of total and partial resection of spinal lateral schwannoma and to assess the values of partial resection of large lateral cervical schwannomas. We performed a retrospective analysis of 27 patients operated for lateral cervical schwannomas in the period 1971–2010, out of which 11 had partial resection. The average follow-up of the patients was 136.4 months, comparing pre- and postoperative clinical picture, time to relapse, dynamics of yearly growth of schwannomas, and the need for re-resection. The average period of preoperative complaint in lateral cervical schwannomas was 19.6 months. Unilateral cervicobrachialgia as a manifestation of radiculopathy was observed in 85% of LCSs, and, was, as a rule the first symptom of the disease. Surgical treatment of 27 patients with LCSs resulted in recovery or improvement of complaints in 80% of cases. The treatment effect did not depend on the degree of resection. Reoperation was done, on average, 16.3 years after partial resection. The residues of lateral cervical schwannomas stopped growing 15 years after partial resection and underwent cystic degeneration. Partial resection of lateral cervical schwannomas is an excellent alternative to total resection, not only for the elderly or in cases of increased surgical risk, but also as a method of choice since it is more readily available to a larger number of surgeons and associated with low percentages of surgically relevant relapses and high percentages of improvement.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Abell MR, Hart WR, Olson JR. Tumors of the peripheral nervous system. Hum Pathol 1970;1:503–551
Leverstein H, Castelijns JA, Snow GB. The value of magnetic resonance imaging in the differential diagnosis of parapharyngeal space tumors. Clin Otolaryngol 1995;20:428–433
Daly JF, Roesler HK. Neurilemmoma of the cervical sympathetic chain. Arch Otolaryngol 1963;77:262–266
Som P, Biller H, Lawson W. Tumors of the parapharyngeal space. Preoperative evaluation, diagnosis and surgical approaches. Ann OtolRhinol Laryngol 1981;90 (suppl 80):3–15
Valentino J, Boggess MA, Ellis JL, Hester TO, Jones RO. Expected neurologic outcomes for surgical treatment of cervical neurilemmomas. Laryngoscope 1998;108:1009–1013
Gore DO, Randow R, Harnford JM. Parapharyngeal neurilemmoma. Surg Gynecol Obstet 1956;103:193–201
Katz AD, Passy V, Kaplan L. Neurogenous neoplasms of major nerves of face and neck. Arch Surg 1971;103:51–56
Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O. Longterm outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases. J Neurosurg. 1995;83:621–626
Chang SC, Schi YM. Neurilemmoma of the vagus nerve. A case report and brief literature review. Laryngoscope 1984;94:946–949
Goel A, Muzumdar D, Nadkarni T, Desai K, Dange N, Chagla A. Retrospective analysis of peripheral nerve sheath tumors of the second cervical nerve root in 60 surgically treated patients.J Neurosurgery Spine 2008; 8:129–134
Pinski J, Halmos G, Shirahige Y, Vittliff L.J, Shally V.A. Inhibition of growth of the human malignant glioma cell line (U87MG) by the steroid hormone antagonist RU486. J Clin Endocrinol metab 1993;77, 1388–1392
De Girolami E, Frosch M, Antonhy D. The central nervous system.In: ai]Cotran R, Kumar V, Robbins S, eds. Robbins Pathologic Basis of Disease. Philadelphia: W.B. Saunders; 1994. p. 1351–1352
Valentino J, Boggess MA, Ellis JL, Hester TO, Jones RO. Expected neurologic outcomes for surgical treatment of cervical neurilemmomas. Laryngoscope 1998;108:1009–1013
Seppala MT, Haltia MJ, Sankila RJ, Jaaskelainen JE, Heiskanen O. Longterm outcome after removal of spinal schwannoma: a clinicopathological study of 187 cases. J Neurosurg. 1995;83:621–626
Chang SC, Schi YM. Neurilemmoma of the vagus nerve. A case report and brief literature review. Laryngoscope 1984;94:946–949
Lonstein JE: Post-laminectomy kyphosis. Clin Orthop Relat Res: 93–100, 1977
Jinnai T, Koyama T: Clinical characteristics of spinal nerve sheath tumors: analysis of 149 cases. Neurosurgery 2005;56: 510–515
Enzinger FM, Weiss SW. Soft Tissue Tumors, 2 nd Ed. Toronto: Mosby; 1988, 725–735
Ogose A, Hotta T, Sato S, Takano R, Higuchi T. Presacral Schwannoma With Purely Cystic Form; Spine 2001; 26(16): 1817–1819
Domanski HA, Akerman M, Engellau J, Gustafson P, Mertens F, Rydholm A. Fine-needle aspiration of neurilemoma (schwannoma). A clinicocytopathologic study of 116 patients. Diagn Cytopathol 2006; 34:403–412
Subramanian N, Rambhatia S, Mahesh L, Menon SV, Krishnakumar S, Biswas J, Noronha OV. Cystic Schwannoma of the Orbit-A Case Series. Orbit. 2005, 24,(2), 125–129
Hirabayashi K, Yasuda M, Umemura S, Itoh H, Itoh J, Yazawa N, Imaizumi T, Yoshiyuki OR. JOP. J Pancreas (Online) 2008; 9(2):203–208
Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: Pictorial review. European Journal of Radiology 2004; 52(3):229–239
Cury J, Ferreira RC, Srougi M. Retroperitoneal schwannoma: Case series and literature review. CLINICS 2007;62(3):359–362
Donnal JF, Backer ME, Mahony MS, Leight GS. Benign retroperitoneal schwannoma. Urology 1988; 31: 332–334
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Stefanović, I., Bošnjaković, P., Kostić, A. et al. Lateral intra-extraspinal cervical schwannomas: Partial versus total resection. cent.eur.j.med 7, 66–72 (2012). https://doi.org/10.2478/s11536-011-0122-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2478/s11536-011-0122-1