Lincoski Chris J, Harter G Dean, Bush David C
Department of Orthopedic Surgery, Geisinger Medical Center, Danville, PA 17822, USA.
Am J Orthop (Belle Mead NJ). 2007 Mar;36(3):E32-6.
We used a hand surgeon's 1978-1994 pathology reports to retrospectively review the incidence, preoperative and postoperative diagnoses, and presenting signs and symptoms of benign nerve tumors. Twenty-four (11.5%) of our series of 208 soft-tissue tumors of the hand and the forearm were benign nerve tumors. Nerve tumors were the third most common tumor after giant cell tumors of tendon sheath and inclusion cysts. Correct preoperative diagnosis was made in only 1 (4.2%) of the 24 cases. Schwannomas and neurofibromas were equally distributed (12 each), and 2 cases of neurofibromatosis (8.3%) were documented. Two (16.7%) of the 12 patients with schwannomas and 4 (33.3%) of the 12 patients with neurofibromas had neurologic symptoms. Six (85.7%) of the 7 digital tumors were dorsally located. In the literature, incidence of benign nerve tumors is much lower (ie, 1%-5%), and preoperative diagnosis consistently incorrect in our study. Incidence of neurologic symptoms (numbness, paresthesia) as presenting symptoms was higher in our study than previously documented. Although benign nerve tumors are most often located on the volar surface of the hand, 25% of the lesions we found were on the dorsal surface of the fingers.
我们使用了一位手外科医生1978年至1994年的病理报告，以回顾性分析良性神经肿瘤的发病率、术前和术后诊断以及临床表现和症状。在我们所研究的208例手部和前臂软组织肿瘤中，有24例（11.5%）为良性神经肿瘤。神经肿瘤是继腱鞘巨细胞瘤和包涵囊肿之后的第三常见肿瘤。24例病例中仅有1例（4.2%）术前诊断正确。神经鞘瘤和神经纤维瘤分布均等（各12例），并有2例记录为神经纤维瘤病（8.3%）。12例神经鞘瘤患者中有2例（16.7%）、12例神经纤维瘤患者中有4例（33.3%）有神经症状。7例指部肿瘤中有6例（85.7%）位于背侧。文献报道中，良性神经肿瘤的发病率要低得多（即1%-5%），而在我们的研究中术前诊断一直不准确。在我们的研究中，作为临床表现的神经症状（麻木、感觉异常）的发生率高于以往报道。尽管良性神经肿瘤最常位于手掌面，但我们发现25%的病变位于手指背侧。
