Chen Mengjie, Li Xiuli, Feng Xinhong
Department of Neurology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Front Neurol. 2023 Jan 16;14:1056341. doi: 10.3389/fneur.2023.1056341. eCollection 2023.
Brachial plexopathy (BP) is easily misdiagnosed due to its complexity and varying clinical presentation. Malignant peripheral nerve sheath tumors (MPNST) can accumulate in the brachial plexus and share symptoms with BP, which may hinder the differential diagnosis between BP induced by radiation or metastases, and MPNST-derived BP, in patients with a history of breast cancer and radiation exposure. A 34-year-old Chinese female presented with MPNST. The tumor involved the brachial plexus. She had a history of breast cancer and radiotherapy. The first consideration was radiation- or breast cancer metastasis-derived BP. Clinical examination was performed. Finally, a diagnosis of MPNST of the brachial plexus was made, which guided an accurate treatment plan. This report highlights the importance of correctly diagnosing BP etiology for guiding precise treatment. BP caused by MPNST needs to be considered in clinical practice, and biopsy plays a central role in the differential diagnosis. Complete local surgical resection can prolong survival of patients with MPNST and improve treatment prognosis.
臂丛神经病变(BP)因其复杂性和临床表现各异而容易被误诊。恶性外周神经鞘瘤(MPNST)可累及臂丛神经并与BP有共同症状,这可能会妨碍对有乳腺癌病史和接受过放疗的患者中,由辐射或转移引起的BP与MPNST源性BP之间的鉴别诊断。一名34岁中国女性患MPNST。肿瘤累及臂丛神经。她有乳腺癌和放疗史。首先考虑的是辐射或乳腺癌转移所致的BP。进行了临床检查。最终诊断为臂丛神经MPNST,这为制定准确的治疗方案提供了指导。本报告强调了正确诊断BP病因以指导精准治疗的重要性。临床实践中需要考虑MPNST引起的BP,活检在鉴别诊断中起核心作用。完整的局部手术切除可延长MPNST患者的生存期并改善治疗预后。