Malignant peripheral nerve sheath tumor in the pelvis: a case report
Abstract Background Malignant peripheral nerve sheath tumors (MPNSTs) are malignancies that arise or differentiate from or infiltrate peripheral nerves and account for approximately 5% of soft-tissue malignancies. Approximately half of MPNSTs develop in patients with neurofibromatosis type 1 (NF1),...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-09-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-023-01733-5 |
| _version_ | 1797451693272596480 |
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| author | Rika Ono Tetsuro Tominaga Takashi Nonaka Yuma Takamura Kaido Oishi Toshio Shiraishi Shintaro Hashimoto Keisuke Noda Terumitsu Sawai Takeshi Nagayasu |
| author_facet | Rika Ono Tetsuro Tominaga Takashi Nonaka Yuma Takamura Kaido Oishi Toshio Shiraishi Shintaro Hashimoto Keisuke Noda Terumitsu Sawai Takeshi Nagayasu |
| author_sort | Rika Ono |
| collection | DOAJ |
| description | Abstract Background Malignant peripheral nerve sheath tumors (MPNSTs) are malignancies that arise or differentiate from or infiltrate peripheral nerves and account for approximately 5% of soft-tissue malignancies. Approximately half of MPNSTs develop in patients with neurofibromatosis type 1 (NF1), a hereditary disease. MPNSTs occur mainly in the trunk, proximal extremities, and neck, but can on rare occasion arise in or near the gastrointestinal tract, and intestinal complications have been reported. We describe herein a case with resection of an MPNST arising in the pelvic region. Case presentation A 51-year-old woman had undergone repeated resections for systemic neurofibrosis associated with NF1. This time, a pelvic tumor was noted on follow-up positron emission tomography computed tomography (CT). She presented with slowly progressive radiating pain in the lower extremities and was referred to our hospital for tumor resection. Contrast-enhanced CT showed a 75 × 58-mm mass in the right greater sciatic foramen directly below a 24 × 28-mm mass. Open pelvic tumor resection was performed for pelvic neurofibroma. The obturator nerve was identified lateral to the main tumor and the sciatic nerve was identified dorsally, then dissection was performed. The closed nerve was spared, while the sciatic nerve was partially dissected and the two tumors were removed. Both tumors were elastic and hard. Pathologic findings were MPNST for the large specimen and neurofibroma with atypia for the small specimen. The patient developed temporary postoperative ileus, but is generally doing well and is currently free of recurrence or radiating pain. The patient is at high risk of recurrence and close monitoring should be continued. Conclusions We encountered a rare case of MPNST. Due to the high risk of recurrence, surgery with adequate margins was performed, with a requirement for appropriate follow-up. |
| first_indexed | 2024-03-09T14:58:12Z |
| format | Article |
| id | doaj.art-7b925097933c49539dff2e3f4bac112f |
| institution | Directory Open Access Journal |
| issn | 2198-7793 |
| language | English |
| last_indexed | 2024-03-09T14:58:12Z |
| publishDate | 2023-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj.art-7b925097933c49539dff2e3f4bac112f2023-11-26T14:03:38ZengSpringerOpenSurgical Case Reports2198-77932023-09-01911410.1186/s40792-023-01733-5Malignant peripheral nerve sheath tumor in the pelvis: a case reportRika Ono0Tetsuro Tominaga1Takashi Nonaka2Yuma Takamura3Kaido Oishi4Toshio Shiraishi5Shintaro Hashimoto6Keisuke Noda7Terumitsu Sawai8Takeshi Nagayasu9Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceDepartment of Surgical Oncology, Nagasaki University Graduate School of Biomedical ScienceAbstract Background Malignant peripheral nerve sheath tumors (MPNSTs) are malignancies that arise or differentiate from or infiltrate peripheral nerves and account for approximately 5% of soft-tissue malignancies. Approximately half of MPNSTs develop in patients with neurofibromatosis type 1 (NF1), a hereditary disease. MPNSTs occur mainly in the trunk, proximal extremities, and neck, but can on rare occasion arise in or near the gastrointestinal tract, and intestinal complications have been reported. We describe herein a case with resection of an MPNST arising in the pelvic region. Case presentation A 51-year-old woman had undergone repeated resections for systemic neurofibrosis associated with NF1. This time, a pelvic tumor was noted on follow-up positron emission tomography computed tomography (CT). She presented with slowly progressive radiating pain in the lower extremities and was referred to our hospital for tumor resection. Contrast-enhanced CT showed a 75 × 58-mm mass in the right greater sciatic foramen directly below a 24 × 28-mm mass. Open pelvic tumor resection was performed for pelvic neurofibroma. The obturator nerve was identified lateral to the main tumor and the sciatic nerve was identified dorsally, then dissection was performed. The closed nerve was spared, while the sciatic nerve was partially dissected and the two tumors were removed. Both tumors were elastic and hard. Pathologic findings were MPNST for the large specimen and neurofibroma with atypia for the small specimen. The patient developed temporary postoperative ileus, but is generally doing well and is currently free of recurrence or radiating pain. The patient is at high risk of recurrence and close monitoring should be continued. Conclusions We encountered a rare case of MPNST. Due to the high risk of recurrence, surgery with adequate margins was performed, with a requirement for appropriate follow-up.https://doi.org/10.1186/s40792-023-01733-5Malignant peripheral nerve sheath tumorsNeurofibromatosis type 1Surgery |
| spellingShingle | Rika Ono Tetsuro Tominaga Takashi Nonaka Yuma Takamura Kaido Oishi Toshio Shiraishi Shintaro Hashimoto Keisuke Noda Terumitsu Sawai Takeshi Nagayasu Malignant peripheral nerve sheath tumor in the pelvis: a case report Surgical Case Reports Malignant peripheral nerve sheath tumors Neurofibromatosis type 1 Surgery |
| title | Malignant peripheral nerve sheath tumor in the pelvis: a case report |
| title_full | Malignant peripheral nerve sheath tumor in the pelvis: a case report |
| title_fullStr | Malignant peripheral nerve sheath tumor in the pelvis: a case report |
| title_full_unstemmed | Malignant peripheral nerve sheath tumor in the pelvis: a case report |
| title_short | Malignant peripheral nerve sheath tumor in the pelvis: a case report |
| title_sort | malignant peripheral nerve sheath tumor in the pelvis a case report |
| topic | Malignant peripheral nerve sheath tumors Neurofibromatosis type 1 Surgery |
| url | https://doi.org/10.1186/s40792-023-01733-5 |
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