J Korean Orthop Assoc.  2023 Apr;58(2):149-156. 10.4055/jkoa.2023.58.2.149 .

A Series of 236 Clinically and Radiographically Diagnosed Benign Peripheral Neural Sheath Tumors: Identifying the Proper Treatment Method for Better Treatment Outcomes

• Park JJ
• Seok HG
• Shin DS

• KMID: 2541470
• DOI: http://doi.org/10.4055/jkoa.2023.58.2.149

Abstract

Purpose
Benign peripheral nerve sheath tumors (BPNSTs) are relatively common neurogenic tumors that arise from nerve sheath cells. Some nerve sheath tumors are treated with surgery, particularly in patients with intolerable pain or neurological dysfunction. Most studies on BPNSTs focus on surgical treatment of the condition. Few studies on the progress of clinically and radiographically diagnosed BPNST patients have been reported. To the best of our knowledge, there are no studies on the factors that influence the decision for the surgical treatment of the patient. This paper aimed at conducting a retrospective analysis of BPNST patients visiting our hospital to understand the best approach for the treatment of BPNST patients.
Materials and Methods
The medical records of 236 patients who were clinically and radiographically diagnosed with BPNSTs from January 2010 to April 2020 were reviewed. In the conservative group, the progress was analyzed by comparing the tumor size and clinical symptoms at the initial visit and the 1-year follow-up. In the surgical patient’s (surgery) group, the progress was analyzed by assessing the clinical symptoms and tumor recurrence 1 year after surgery. The clinical and radiological characteristics of the conservative and the surgery groups were compared at the time of diagnosis.
Results
During follow-up, 154 patients (65.3%) continued conservative treatment and 82 patients (34.7%) underwent surgical treatment. The conservative group showed no significant differences in tumor size and clinical symptoms between the initial diagnosis and the one-year follow-up. Most of the patients who underwent surgery returned to daily life with recovery from their existing symptoms, and recurrence was confirmed in one case. The surgery group showed a higher severity and frequency in all the clinical symptoms except for local swelling.
Conclusion
Neurological deficits and severe neurological pain were important factors when considering the surgical management of BPNST. Excellent clinical and oncological outcomes were seen with surgical treatment, and it could thus be a good option to reduce the frequency of follow-up visits and concerns about malignant transformation.

Keyword

peripheral nerve sheath tumors; conservative treatment; operative