Chick Grégoire, Victor Jan, Hollevoet Nadine
Acta Orthop Belg. 2020 Mar;86(1):151-161.
Benign peripheral nerve tumours are rare lesions. The surgical treatment and clinical outcomes depend on the resectability. The aim of this retrospective study was to identify clinical or radiological features that may predict the surgical technique that should be used to improve clinical outcome. Eighty-two patients were diagnosed with solitary benign peripheral nerve tumours. Fifty-five tumours were surgically resectable, and 27 were nonresectable. Pre-operative magnetic resonance imaging and ultrasound were used, which were predictive of the neural origin of the tumours in 87% (39/45) of cases imaged. In 78% (50/64) of cases imaged, an origin from the nerve sheath (peripheral nerve sheath tumour), or from non-neural elements was possible. However, no imaging or clinical criteria were identified that could determine tumour resectability preoperatively. The diagnosis of solitary peripheral nerve tumour still relies on the macroscopic appearance and definitive histology after epineurotomy.
良性周围神经肿瘤是罕见的病变。手术治疗及临床结果取决于肿瘤的可切除性。本回顾性研究的目的是确定可能预测应采用何种手术技术以改善临床结果的临床或影像学特征。82例患者被诊断为孤立性良性周围神经肿瘤。55例肿瘤可手术切除,27例不可切除。术前使用了磁共振成像和超声检查,在87%(39/45)的成像病例中可预测肿瘤的神经起源。在78%(50/64)的成像病例中,肿瘤有可能起源于神经鞘(周围神经鞘瘤)或非神经成分。然而,未发现能够术前确定肿瘤可切除性的影像学或临床标准。孤立性周围神经肿瘤的诊断仍依赖于神经外膜切开术后的大体外观和确诊组织学检查。