Multinodular plexiform tumors of major peripheral nerves: A practical overview

Area of Science:

• Neurosurgery
• Oncology
• Pathology

Background:

• Multinodular/plexiform schwannomas and neurofibromas of major nerves are rare and challenging to diagnose preoperatively.
• Surgical intervention is indicated for progressive tumors but carries a higher risk of neurological damage compared to conventional nerve tumors.
• Existing literature often focuses on pathological aspects, lacking specific clinical and surgical management guidelines.

Purpose of the Study:

• To present neurosurgical experience with multinodular/plexiform schwannomas and neurofibromas.
• To provide insights for the management of these rare nerve tumors.
• To highlight clinical, surgical, and pathological differences between these tumor types.

Main Methods:

• Analysis of clinical, radiological, and pathological data.
• Inclusion of a consecutive case series of plexiform/multinodular nerve tumors operated within the last five years.
• Focus on neurosurgical interventions for major nerve tumors.

Main Results:

• Neurofibromas were more frequent than schwannomas in the studied series.
• Three cases were associated with Neurofibromatosis type 1 (NF-1).
• Surgical complexity and early outcomes were linked to pre-surgical neurological status and tumor histological grade.

Conclusions:

• Multinodular-plexiform schwannomas and neurofibromas exhibit distinct clinical, surgical, and pathological characteristics.
• Accurate differential diagnosis is crucial for appropriate surgical planning and management.
• Neurosurgical expertise is essential for managing these complex tumors of major nerves.