Schwannoma of the Upper Extremity: A Clinical Series

Hossein Azaditalab; Abdolnaser Farzan; Hossein Hamdollahzade; Ramin  Shayan-Moghadam; Mosayeb Soleymani

doi:10.18502/jost.v10i1.14967

Hossein Azaditalab Felowship of Hand Surgery, Department of Orthopedic and Trauma Surgery, Imam khomeini Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Abdolnaser Farzan Professor, Department of Orthopedic and Trauma Surgery, Imam khomeini Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Hossein Hamdollahzade Felowship of Hand Surgery, Department of Orthopedic and Trauma Surgery, Imam khomeini Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
Ramin Shayan-Moghadam Resident, Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran
Mosayeb Soleymani Resident, Department of Orthopedic and Trauma Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran; Center of Orthopedic Trans-Disciplinary Applied Research (COTAR), Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/jost.v10i1.14967

Keywords: Soft Tissue Neoplasms; Neurilemmoma; Schwann Cells; Upper Extremity

Abstract

Background: Schwannoma, the most common primary neural tumor of the upper extremity, arises from Schwann cells of the nerve sheet. The tumor is usually painless and slow-growing. Symptomatic masses could be treated through intra- or extra-capsular excision. Herein, we aim to evaluate the long-term results of surgical treatment of 12 cases of upper extremity Schwannoma.

Methods: Twelve cases of confirmed Schwannoma who were treated in Imam Khomeini University Hospital, Tehran, Iran, from 2011 to 2022, were included in our case series. All operations were done using loupe magnification or under a microscope. Age, sex, location of the mass, size of the tumor, affected nerve, histological diagnosis, and clinical follow-up, including the neurological status of the patients, were documented.

Results: Twelve patients with a mean age of 44 years were included. Seven (58.3%) were men and five (41.66%) were women. The mean follow-up period was 45 months (range: 6-135). The hand was the most common location of involvement and the digital nerve was the most frequent origin of Schwannoma. Postoperative evaluation showed no tumor recurrence and pain resolved in all twelve patients (100%). Sensory dysfunction resolved completely in 5 out of 8 patients who reported sensory impairment preoperatively (62.5%) and no motor function improvement was seen in the patient with motor deficit.

Conclusion: Adequate operative techniques can lead to complete tumor removal without neurological loss or recurrence. Neural function improvement in most cases is achieved. New neurologic impairment after excision of Schwannoma is rare.