Surgical management of peripheral nerve sheath tumours: a 10-year retrospective UK study

Peripheral nerve sheath tumours (PNSTs) are predominantly benign lesions. Surgical resection is the gold-standard treatment when symptoms are troublesome, progressive and/or when formal tissue diagnosis is necessary; however, the risk of postoperative neurological deficits and the predictors of outcome are not well defined.

What are the clinical characteristics, postoperative outcomes, and predictors of complications following PNST surgery?

A retrospective chart review was conducted of all consecutive PNST resections performed at a single tertiary NHS neurosurgical centre over a ten-year period between 1st March 2015 and 31st May 2025. Demographic data, presenting symptoms, tumour characteristics and follow-up outcomes were collected and analysed. Binomial logistic regression was used to identify predictors of worse sensory outcomes.

83 surgeries were performed in 77 patients (median age 48 years, 50.6% male). 74.7% of tumours were schwannoma. Pain was the predominant presenting symptom (in 78.3%), and improved postoperatively in 93.8% of cases, with no new postoperative pain. New functionally impairing postoperative sensory symptoms or weakness occurred in 2.5% and 1.3% of patients, respectively. Preoperative neuropathic tenderness was independently associated with worse sensory outcome.

PNST surgery offers reliable pain relief with a low risk of severe neurological morbidity. Sensory disturbances are common but usually mild. Patients with preoperative nerve irritability on examination may be at higher risk of postoperative sensory deficits and should be appropriately counselled.