Sanchez Angel Puente, Gallardo-Navarro Elias, López Brenda Jiménez
Plastic and Reconstructive Surgery, Instituto Nacional de Pediatría, Mexico City, Mexico.
Resident of General Surgery, Hospital Español, Mexico City, Mexico.
Int J Surg Case Rep. 2025 Aug 13;135:111800. doi: 10.1016/j.ijscr.2025.111800.
Malignant peripheral nerve sheath tumor (MPNST), also called malignant schwannoma, neurofibrosarcoma and neurogenic sarcoma, is a malignant neoplastic lesion originating in the Schwann cells of the sheath lining of peripheral nerves.
A 2-year-old, 7-month-old female patient, was admitted to our clinic due to progressive enlargement of the right forearm, physical examination revealed a tumor on the right forearm, painless, fixed to adjacent structures, hard, with erythema and swelling in the upper part of the lesion, complete surgical excision of the tumor with left inguinal graft was performed, covering the entire resected surgical defect. The pathology report was a malignant peripheral nerve sheath tumor. The patient was discharged with good clinical evolution, the MPNST was low grade so no adjuvant treatment based on radiotherapy or chemotherapy was administered.
These malignant tumors are recognized for being aggressive, for high rates of local recurrence and distant metastases, constitute approximately 5 % to 10 % of all soft tissue sarcomas, and arise mainly from peripheral nerve sheath components, with poor prognosis.
This case shows the clinical manifestations and complications that can be expected with these tumors, as well as their reconstructive treatment with adequate esthetic and functional results in young patients.
恶性外周神经鞘瘤(MPNST),也称为恶性施万细胞瘤、神经纤维肉瘤和神经源性肉瘤,是一种起源于外周神经鞘膜施万细胞的恶性肿瘤性病变。
一名2岁7个月大的女性患者因右前臂逐渐肿大入院,体格检查发现右前臂有一肿瘤,无痛,与相邻结构固定,质地硬,病变上部有红斑和肿胀,行肿瘤完整切除并取自体左腹股沟皮瓣移植,覆盖整个切除后的手术缺损。病理报告为恶性外周神经鞘瘤。患者临床病情好转出院,该MPNST为低级别,因此未给予基于放疗或化疗的辅助治疗。
这些恶性肿瘤以侵袭性强、局部复发率和远处转移率高而著称,约占所有软组织肉瘤的5%至10%,主要起源于外周神经鞘成分,预后较差。
本病例展示了这些肿瘤可能出现的临床表现和并发症,以及在年轻患者中进行具有良好美学和功能效果的重建治疗情况。