Jia Xiaotian, Yang Jianyun, Chen Lin, Yu Cong, Kondo Tadashi
Department of Hand Surgery, Huashan Hospital, Fudan University, Key Laboratory of Hand Reconstruction, Ministry of Health, Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China.
Division of Pharmacoproteomics, National Cancer Center Research Institute, Tokyo, Japan.
Clin Neurol Neurosurg. 2016 Sep;148:91-5. doi: 10.1016/j.clineuro.2016.07.009. Epub 2016 Jul 4.
Primary brachial plexus tumors are extremely rare and the treatment is challengeable. Our aim is to share the experiences in the treatment of primary brachial plexus tumors.
A retrospective analysis of 143 patients with primary brachial plexus tumors was made in our department from January 2001 to December 2012. The clinical presentation of the patients, the characteristics and pathological results of the tumors and the prognosis were described.
Seventy-eight males and sixty-five female were enrolled. The mean age was 48.17 years old. A palpable mass was the most common clinical presentation occurred in 129 patients. The trunks of the brachial plexus were the locations where the tumors originated with high possibility, with 68 cases. Benign tumors were composed of 119 schwannomas and 12 neurofibromas, while malignant tumors were composed of 8 malignant peripheral nerve sheath tumors, 2 malignant granular cell tumors, 1 synovial sarcoma and 1 peripheral primitive neuroectodermal tumor. Appropriate surgical method, radiotherapy and chemotherapy were used according to the condition during operation, preoperative examinations and pathological result. The survival rate was 50.00% with a 3-year follow-up. Local recurrence happened in 7 patients. Five patients presented Metastasis.
Appropriate surgical method is the key for the treatment of different brachial plexus tumors. Surgery has a great effect on the treatment of benign tumors. For malignant tumors, adjuvant radiotherapy or chemotherapy should be used according to the pathological result. The general prognosis for malignant brachial plexus tumors is less than ideal.
原发性臂丛神经肿瘤极为罕见，其治疗具有挑战性。我们的目的是分享原发性臂丛神经肿瘤的治疗经验。
对2001年1月至2012年12月在我科收治的143例原发性臂丛神经肿瘤患者进行回顾性分析。描述了患者的临床表现、肿瘤的特征及病理结果和预后情况。
纳入78例男性和65例女性。平均年龄为48.17岁。129例患者最常见的临床表现为可触及肿块。臂丛神经干是肿瘤最有可能起源的部位，有68例。良性肿瘤包括119例神经鞘瘤和12例神经纤维瘤，恶性肿瘤包括8例恶性外周神经鞘膜瘤、2例恶性颗粒细胞瘤、1例滑膜肉瘤和1例外周原始神经外胚层肿瘤。根据术中情况、术前检查及病理结果采用合适的手术方法、放疗和化疗。3年随访生存率为50.00%。7例患者出现局部复发。5例患者出现转移。
合适的手术方法是治疗不同臂丛神经肿瘤的关键。手术对良性肿瘤的治疗效果显著。对于恶性肿瘤，应根据病理结果采用辅助放疗或化疗。恶性臂丛神经肿瘤的总体预后不太理想。
