• Journal of Korean Neurosurgical Society
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• v.47 no.1
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• pp.51-54
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• 2010

Surgery has a key role in the treatment of malignant peripheral nerve sheath tumors (MPNSTs), but the resectability of paraspinal MPNSTs is only 20%. Therefore, spinal MPNSTs show frequent recurrence and poor prognosis. Local recurrence is much more common than metastasis for MPNSTs, and surgery still has a key role in the treatment of local recurrence. Therefore, it is important that recurrence must be detected before resectability is lost. However, no evidence-based follow-up protocol has been established for MPNST. The authors performed gross total resection in a 34-year-old woman presented with thoracic MPNST. Adjuvant radiotherapy and chemotherapy were not administered since these adjuvant therapies generally do not improve survival in MPNST and may cause additional neurovascular damage. Instead, the authors monitored the primary site every 3 months using magnetic resonance imaging to detect local recurrence at the earliest opportunity. The tumor recurred locally on two occasions without overt symptoms at 21 and 24 months postoperatively. These recurrences were treated successfully by gross total removal.

• Korean Journal of Veterinary Research
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• v.54 no.1
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• pp.7-12
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• 2014

Peripheral nerve sheath tumors (PNSTs) are heterogeneous tumor groups of peripheral nerves that originate from either Schwann cells or modified Schwann cells, fibroblasts, or perineural cells. In this study, signalment and clinical data such as tumor location and size were evaluated for 15 cases of PNSTs collected from local animal hospitals. The mean age of dogs with malignant PNST was higher than that of dogs with benign PNST. Additionally, the male to female ratio in dogs with PNST was 1 : 4. In dogs with PNST, the primary sites of involvement were the hindlimb, forelimb, around the mammary glands, the neck, and the abdomen. Histiopathologic examination revealed that eight PNSTs were benign and seven were malignant. The tumor cells were composed of loosely to densely arranged interlacing bundles and wavy spindle cells arranged in short bundles, palisading, and whirling. High mitotic figures, local invasion, multifocal necrosis and atypical multinucleated giant cells were observed in malignant PNST cases. All PNSTs showed immunoreactivity for vimentin and S-100. However, only 93.3% and 73.3% were immunoreactive for NSE and GFAP, respectively. Overall, these results indicated that immunohistochemical markers such as vimentin, S-100 and NSE could help confirm the diagnosis of canine PNSTs.

• Archives of Reconstructive Microsurgery
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• v.26 no.1
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• pp.23-25
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• 2017

The malignant peripheral nerve sheath tumor (MPNST) originates from neurofibromatosis type 1 (NF1). Because NF1 patients have many accompaniments with growth of additional masses, they usually overlook potential malignant changes in their masses. Our patient had two growing mass near the left elbow for several months; however, she ignored these masses until 7 days prior to writing this article, at which time they began bleeding. Traditionally, sarcoma including MPNST treatment consisted of amputation of the involved extremity. However, treatment now consists of surgical resection with adjuvant therapy. Therefore, we conducted resection of the mass and subsequent coverage with a local advancement flap. We believe that the most effective treatment for MPNST is early diagnosis and fast surgery, coupled with notification that there is always potential for malignant change in NF1 patient's masses.

• Journal of Clinical Otolaryngology Head and Neck Surgery
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• v.29 no.2
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• pp.245-249
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• 2018

Neurilemmoma is a benign tumor that originates from the Schwann cell. It frequently occurs in head and neck regions, but neurilemmoma of external auditory canal is extremely rare. Here, we report a very rare case of 36-year-old male with a tumor located in the posterior wall of external auditory canal, preoperatively suspected as neurilemmoma originated from Arnold's nerve by temporal bone magnetic resonance imaging. The tumor mass was surgically excised and pathologically confirmed as a neurilemmoma.

• Journal of the Korean Society of Radiology
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• v.84 no.3
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• pp.770-775
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• 2023

Malignant peripheral nerve sheath tumor (MPNST), a rare soft-tissue sarcoma, is most commonly located in the trunk, extremities, and head and neck, but rare in the breast. We report a metastatic breast MPNST in a 27-year-old woman with neurofibromatosis type 1 (NF-1). Chest computed tomography revealed a well-defined, oval, mildly enhancing nodule in the right breast. US revealed a circumscribed, oval, heterogeneous echoic mass with vascularity and intermediate elasticity in the right upper outer breast. The breast mass was excised and diagnosed as MPNST on histopathology evaluation. Although rare, it should be included in the differential diagnosis of breast mass in NF-1 patient.

• Journal of Korean Neurosurgical Society
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• v.52 no.2
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• pp.138-143
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• 2012

Objective : This is a retrospective review of 22 surgically treated benign and malignant tumors of brachial plexus region to describe clinical presentation, the characteristics of brachial plexus tumor and clinical outcomes with a literature review. Methods : Twenty-one patients with consecutive 22 surgeries for primary brachial plexus tumors were enrolled between February 2002 and November 2011 were included in this study. The medical records of all patients were reviewed. Results : Eleven male and 10 female patients were enrolled. Mean age was 39 years. Three patients had brachial plexus tumor associated with neurofibromatosis (13.6%). Presenting signs and symptoms included parenthesis and numbness (54.5%), radiating pain (22.7%), direct tenderness and pain (27.2%), palpable mass (77.3%). Twelve patients presented preoperative sensory deficit (54.5%) and 9 patients presented preoperative motor deficit (40.9%). Twenty tumors (90.9%) were benign and 2 tumors (9.1%) were malignant. Benign tumors included 15 schwannomas (68.2%), 4 neurofibromas (18.2%) and 1 granular cell tumor (4.5%). There were 1 malignant peripheral nerve sheath tumor (MPNST) and 1 malignant granular cell tumor. Gross total resection was achieved in 16 patients (72.7%), including all schwannomas, 1 neurofibroma. Subtotal resection was performed in 6 tumors (27.3%), including 3 neurofibromatosis associated with brachial plexus neurofibromas, 1 MPNST and 2 granular cell tumor in one patient. Conclusion : Resection of tumor is the choice of tumor in the most of benign and malignant brachial plexus tumors. Postoperative outcomes are related to grade of resection at surgery and pathological features of tumor.

• Journal of Korean Neurosurgical Society
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• v.29 no.6
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• pp.744-747
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• 2000

Objectives : The purpose of this study was to evaluate the clinical features of the epidermoid tumor of posterior fossa and to assess the surgical outcome. Methods : We reviewed the clinicoradiological records of 10 epidermoid tumor of posterior fossa, treated surgically at our hospital between 1991 and 1996. Results : The mean age of onset was 36 years old and mean duration of symptom was 5.2 years. Six were men and four were women. The location of tumors were cerebellopontine angle(CPA) 5 cases, cerebellum(Cbll)& 4th ventricle 3 cases, foramen magnum 1 case, and pineal region extended to Cbll and 4th ventricle 1 case. Common clinical features were trigeminal neuralgia in 3 cases, cerebellar signs 2 case, headache 2 cases, hemifacial spasm with deafness 1 case, cbll signs and multiple cranial nerve dysfunctions 1 case. One CPA epidermoid had no clinical symptom and sign associated with the tumor. The surgical approaches were suboccipital approach in 9 cases and one transcallosal approach to the tumor of pineal region. The extent of surgical removal was gross total resection in 5 cases and near total or subtotal resection in 5. Two patients with CPA tumor were complicated with facial paresis. One patient with tumor located in cerebellum extended into cisterna magna had postoperative vocal cord paresis. All complicated cases had severe adhesion of tumor capsule with brainstem or cranial nerve. The mean duration of follow up was 26 months. The overall outcome was improvement of symptoms and signs in 6 cases and stationary 4 cases. During follow up, imaging study was done in 7 patients and none of them had finding of tumor recurrence. Conclusion : We conclude that recurrence of tumor is rare in both total and subtotal resected cases, but long-term follow-up is required. Aggressive removal of tumor capsule that adhesed to brianstem or cranial nerve is avoided for preventing severe postoperative complication.

• The Journal of the Korean bone and joint tumor society
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• v.9 no.2
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• pp.212-216
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• 2003

A Common peroneal nerve palsy caused by ganglionic cyst is very rare condition but well recognised entities. There have been three previous reports describing the magnetic resonance image (MRI) findings of peroneal nerve entrapment due to a ganglionic cyst. Ultrasonography, MRI, and electromyography (EMG), nerve conduction velocity (NCV), and microscopic examination were taken for diagnosis. A tubular structure near the fibular neck extending longitudinally over several slices with an inferior extension towards the superior tibiofibular joint with high T2 signal intensity was characteristic. The peroneal nerve was exposed and the ganglionic cyst was excised. The nerve was paralysed immediately after operation, but at 4 month after operation, started recovery of the function gradually and has recovered completely at 7 month. MRI is helpful to detect the extent, location, and origin of the cyst. Meticulous surgical excision can provide favorable result.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.498-500
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• 2011

Purpose: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. Methods: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a $1{\times}1cm$ sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a $1{\times}0.5cm$ sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. Results: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. Conclusion: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.42-48
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• 1993

A group of 49 patients with neurogenic tumor in head and neck except intracranial tumor & Von-recklinghausen's disease was treated at the Department of Surgery. Presbyterian Medical Center during 12 years from January, 1980 to December, 1991. Of the 49 cases, 24 cases were neurilemmoma, 23 cases neurofibroma and 2 cases malignant schwannoma. The lateral cervical region was the commonest location of the neurogenic tumors, 24 cases (49%) arose from posterior triangle of neck and 12 cases from anterior triangle of neck. The origin of nerve was identified in 28 cases(57%). Cervical plexus(10 cases) and brachial plexus(7 cases) were most commonly affected. The most common site of neurogenic tumors arose from cranial nerve was anterior cervical triangle.