[Tumors of peripheral nerves of extremities and the brachial plexus and their surgical treatment]

Abstract

Background: The author presents the results of 32 operations in 30 patients to whom in the course of 11 years, from 1990-2001 by the microtechnique 32 tumours of peripheral nerves of the extremities and the brachial plexus were removed.

Patients and methods: In 26 patients 28 tumours of the peripheral nerves of the extremities were removed and in 4 patients 4 tumours of the brachial plexus were removed. Three of the tumours of the brachial plexus spread intraspinally. 31 tumours of the nervous sheaths included 19 schwannomas and 12 neurofibromas. Of 12 neurofibromas six were found in four patients with Recklinghausen's disease (VRD). One patient had a tumour of non-neural elements--a lipoma. The authors did not encounter malignant tumours of nervous sheaths, benign or metastatic malignant ones which compressed or invaded the nerve or plexus. The results were evaluated according to Donner's classification of motor and sensitive functions.

Results: Motor functions improved but remained unaltered in 17 (89%) patients with schwannomas and in 5 (83.3%) patients with pain in the area of the affected nerve either complete or partial mitigation of symptoms occurred. In neurofibromas in 3 (50%) patients motor functions improved or remained unaltered and all patients had a partial or complete regression of painful syndromes. In 4 patients with VRD 6 tumours of the peripheral nerves of the extremities were removed, in all the motor functions improved or remained unalterted and in all a partial or complete regression of pain syndromes was recorded. The results were more favourable in smaller, more distant tumours of the nerve sheaths.

Conclusion: Patients should be operated in departments concerned with problems of peripheral nerves.