Pertea Mihaela, Filip Alexandru, Huzum Bogdan, Lunca Sorinel, Carp Claudiu, Mitrea Mihaela, Toader Paula, Luca Stefana, Moraru Dan Cristian, Poroch Vladimir, Veliceasa Bogdan
Faculty of Medicine, "Grigore T Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Department of Plastic Surgery and Reconstructive Microsurgery, "Sf. Spiridon" Emergency County Hospital, 700111 Iasi, Romania.
Diagnostics (Basel). 2022 May 26;12(6):1319. doi: 10.3390/diagnostics12061319.
Although schwannoma (neurilemmoma) is the most common tumor of the peripheral nerve, its low incidence, slow growth and vague symptoms often lead to misdiagnosis or delayed diagnosis. The aim of the study is to present a series with a large number of schwannomas in the upper limbs, some with very rare occurrence.
We report 17 patients with a mean age of 58.5 years and upper limb schwannomas, located on the median, ulnar and radial nerves, but also on the posterior interosseous nerve and digital collateral nerves. The diagnosis was made by clinical examination and imaging tests, and in no case was a preoperative biopsy performed. Surgical treatment was established based on symptoms or aesthetic concerns. In all cases, a diagnosis of schwannoma was confirmed through histopathological and immunohistochemical examinations.
For all patients, a complete tumor enucleation was performed under a surgical microscope. No recurrence was recorded at 2 years after surgery. Patient satisfaction was good, with complete socio-professional integration in all cases.
Although more frequently present on the main nerve trunks, schwannoma may be present on the collateral digital nerves in rare cases. A correct technique with complete tumor excision offers excellent postoperative outcomes and avoids recurrences.
尽管施万细胞瘤（神经鞘瘤）是周围神经最常见的肿瘤，但其发病率低、生长缓慢且症状不明确，常导致误诊或延迟诊断。本研究的目的是报告一组大量上肢施万细胞瘤病例，其中一些病例非常罕见。
我们报告了17例平均年龄为58.5岁的上肢施万细胞瘤患者，肿瘤位于正中神经、尺神经、桡神经，也位于骨间后神经和指侧副神经。通过临床检查和影像学检查进行诊断，无一例进行术前活检。根据症状或美观需求确定手术治疗方案。所有病例均通过组织病理学和免疫组化检查确诊为施万细胞瘤。
所有患者均在手术显微镜下进行了完整的肿瘤摘除术。术后2年无复发记录。患者满意度良好，所有病例均实现了完全的社会职业融入。
尽管施万细胞瘤更常出现在主要神经干上，但在罕见情况下也可能出现在指侧副神经上。采用正确的技术完整切除肿瘤可提供良好的术后效果并避免复发。
