Surgical Approaches to Brachial Plexus Schwannomas: A Multidisciplinary Case Report

Brachial plexus schwannomas are rare tumors requiring individualized surgical planning. Despite established surgical principles, the optimal approach varies substantially by tumor location, and direct comparative data across techniques remain limited.

We present three cases illustrating distinct surgical strategies. A 59-year-old woman with foraminal and intradural extension underwent staged posterior laminectomy followed by supraclavicular resection, who recovered with no clinically significant neurologic deficits. A 69-year-old woman with upper trunk involvement had successful supraclavicular excision with complete symptom resolution. A 68-year-old man with a retroclavicular tumor required transclavicular access via clavicular osteotomy; he experienced immediate pain relief but developed osteotomy nonunion requiring revision fixation before achieving full functional recovery at 2.5 years.

These cases demonstrate that approach selection should be driven by tumor location, anatomical extent, and intradural involvement. Careful anatomical assessment and multidisciplinary collaboration are important considerations for maximizing resection while preserving neurological function.