Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification
Removal of benign peripheral nerve sheath tumors (bPNST) represents a surgical challenge. The morphological relation of bPNST and healthy nerve fascicles are of utmost importance for achieving both removal of the entire tumor and preservation of functional integrity of the peripheral nerve. Thus, we...
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MDPI AG
2022-01-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/3/552 |
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| author | Matthias Holzbauer Kathrin Aufschnaiter-Hießböck Maximilian Zaussinger Oskar C. Aszmann Manfred Schmidt |
| author_facet | Matthias Holzbauer Kathrin Aufschnaiter-Hießböck Maximilian Zaussinger Oskar C. Aszmann Manfred Schmidt |
| author_sort | Matthias Holzbauer |
| collection | DOAJ |
| description | Removal of benign peripheral nerve sheath tumors (bPNST) represents a surgical challenge. The morphological relation of bPNST and healthy nerve fascicles are of utmost importance for achieving both removal of the entire tumor and preservation of functional integrity of the peripheral nerve. Thus, we intraoperatively assessed the morphological patterns between bPNST and nerve fascicles using photo documentation obtained between January 2009 and September 2021. In 31 patients (20 women and 11 men) with a mean age of 48 ± 18 years a total of 34 bPNST were removed. Four constant morphological patterns between bPNST relatively to nerve fascicles were detected: (1) bPNST is located peripherally (<i>n</i> = 16), (2) it splits the nerve into two main fascicles (<i>n</i> = 5), (3) it totally splits up the nerve out of the nerve’s center (<i>n</i> = 8) und (4) it encloses the nerve and its fascicles (<i>n</i> = 5) without any detectable boundary layer. Histology revealed 28 schwannomas, five neurofibromas, and one perineurioma. The proposed classification reflects the increasing complexity of tumor removal with a higher type number. This might be beneficial for preoperative diagnostics, i.e., high-resolution ultrasound or MRI-tractography, as well as for planning the bPNST’s surgical resection and the possible need for nerve reconstruction. |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:41:50Z |
| publishDate | 2022-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-6291e7880f454fb0ac1ef750b51a53f82023-11-23T16:50:12ZengMDPI AGJournal of Clinical Medicine2077-03832022-01-0111355210.3390/jcm11030552Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and ClassificationMatthias Holzbauer0Kathrin Aufschnaiter-Hießböck1Maximilian Zaussinger2Oskar C. Aszmann3Manfred Schmidt4Section of Plastic and Reconstructive Surgery, Department of General Surgery, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020 Linz, AustriaFaculty of Medicine, Johannes Kepler University Linz, Altenbergerstraße 69, 4020 Linz, AustriaSection of Plastic and Reconstructive Surgery, Department of General Surgery, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020 Linz, AustriaDepartment of Plastic and Reconstructive Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, AustriaSection of Plastic and Reconstructive Surgery, Department of General Surgery, Med Campus III, Kepler University Hospital Linz, Krankenhausstrasse 9, 4020 Linz, AustriaRemoval of benign peripheral nerve sheath tumors (bPNST) represents a surgical challenge. The morphological relation of bPNST and healthy nerve fascicles are of utmost importance for achieving both removal of the entire tumor and preservation of functional integrity of the peripheral nerve. Thus, we intraoperatively assessed the morphological patterns between bPNST and nerve fascicles using photo documentation obtained between January 2009 and September 2021. In 31 patients (20 women and 11 men) with a mean age of 48 ± 18 years a total of 34 bPNST were removed. Four constant morphological patterns between bPNST relatively to nerve fascicles were detected: (1) bPNST is located peripherally (<i>n</i> = 16), (2) it splits the nerve into two main fascicles (<i>n</i> = 5), (3) it totally splits up the nerve out of the nerve’s center (<i>n</i> = 8) und (4) it encloses the nerve and its fascicles (<i>n</i> = 5) without any detectable boundary layer. Histology revealed 28 schwannomas, five neurofibromas, and one perineurioma. The proposed classification reflects the increasing complexity of tumor removal with a higher type number. This might be beneficial for preoperative diagnostics, i.e., high-resolution ultrasound or MRI-tractography, as well as for planning the bPNST’s surgical resection and the possible need for nerve reconstruction.https://www.mdpi.com/2077-0383/11/3/552benign peripheral nerve sheath tumorclassificationneurofibromaschwannomatumor enucleation |
| spellingShingle | Matthias Holzbauer Kathrin Aufschnaiter-Hießböck Maximilian Zaussinger Oskar C. Aszmann Manfred Schmidt Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification Journal of Clinical Medicine benign peripheral nerve sheath tumor classification neurofibroma schwannoma tumor enucleation |
| title | Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification |
| title_full | Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification |
| title_fullStr | Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification |
| title_full_unstemmed | Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification |
| title_short | Morphological Relation of Peripheral Nerve Sheath Tumors and Nerve Fascicles: Prospective Study and Classification |
| title_sort | morphological relation of peripheral nerve sheath tumors and nerve fascicles prospective study and classification |
| topic | benign peripheral nerve sheath tumor classification neurofibroma schwannoma tumor enucleation |
| url | https://www.mdpi.com/2077-0383/11/3/552 |
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