Modern treatment of perineuriomas: a case-series and systematic review.
Decompression and neurolysis
Intraneural perineurioma
Surgical treatment
Target fascicular biopsy
Journal
BMC neurology
ISSN: 1471-2377
Titre abrégé: BMC Neurol
Pays: England
ID NLM: 100968555
Informations de publication
Date de publication:
13 Feb 2020
13 Feb 2020
Historique:
received:
13
08
2019
accepted:
06
02
2020
entrez:
15
2
2020
pubmed:
15
2
2020
medline:
2
6
2020
Statut:
epublish
Résumé
Perineuriomas are rare benign peripheral nerve sheath tumours of perineurial cell origin and can be classified into intraneural and extraneural perineuriomas. They most commonly present a mononeuropathy of gradual onset and slow progression, resulting in progressive neurological deficits like hypoesthesia or motor weakness. Therapy is still variable. Aim of the study was to compare our surgical treatment and our follow-up regime including high-resolution nerve sonography with the current literature to evaluate best treatment of perineuriomas. Retrospective analysis of our dataset "peripheral nerve lesion" to identify patients suffering from perineuriomas between 01.01.2012 until 31.12.2018. Surgical treatment and the follow-up examination of three patients were described. Additionally, a systematic review including PubMed, the Cochrane Collaboration Library, Scopus and Google Scholar was performed for literature published between January 1, 1990 and October 31, 2019 independently by 2 authors. In the first case, the left ulnar nerve was affected. In the second case, the left peroneal nerve and in the third case the right median nerve was affected. High-resolution nerve sonography was performed in each case. All patients underwent interfascicular neurolysis combined with a targeted fascicular biopsy under electrophysiological monitoring. Neurological deficits improved subsidized by rehabilitation. Surgical therapy and the neurological outcome were compared with literature. Systematic review revealed 22 articles, which met the inclusion criteria. Therefore, demographics, surgical treatment and neurological outcome of 77 patients were analysed. Perineuriomas are rare benign nerve sheath tumours with a slow progression, sometimes difficult to diagnose. Decompression and neurolysis may improve neurological deficits. High resolution nerve sonography might serve as a helpful additional diagnostic tool in this process.
Sections du résumé
BACKGROUND
BACKGROUND
Perineuriomas are rare benign peripheral nerve sheath tumours of perineurial cell origin and can be classified into intraneural and extraneural perineuriomas. They most commonly present a mononeuropathy of gradual onset and slow progression, resulting in progressive neurological deficits like hypoesthesia or motor weakness. Therapy is still variable. Aim of the study was to compare our surgical treatment and our follow-up regime including high-resolution nerve sonography with the current literature to evaluate best treatment of perineuriomas.
METHODS
METHODS
Retrospective analysis of our dataset "peripheral nerve lesion" to identify patients suffering from perineuriomas between 01.01.2012 until 31.12.2018. Surgical treatment and the follow-up examination of three patients were described. Additionally, a systematic review including PubMed, the Cochrane Collaboration Library, Scopus and Google Scholar was performed for literature published between January 1, 1990 and October 31, 2019 independently by 2 authors.
RESULTS
RESULTS
In the first case, the left ulnar nerve was affected. In the second case, the left peroneal nerve and in the third case the right median nerve was affected. High-resolution nerve sonography was performed in each case. All patients underwent interfascicular neurolysis combined with a targeted fascicular biopsy under electrophysiological monitoring. Neurological deficits improved subsidized by rehabilitation. Surgical therapy and the neurological outcome were compared with literature. Systematic review revealed 22 articles, which met the inclusion criteria. Therefore, demographics, surgical treatment and neurological outcome of 77 patients were analysed.
CONCLUSIONS
CONCLUSIONS
Perineuriomas are rare benign nerve sheath tumours with a slow progression, sometimes difficult to diagnose. Decompression and neurolysis may improve neurological deficits. High resolution nerve sonography might serve as a helpful additional diagnostic tool in this process.
Identifiants
pubmed: 32054523
doi: 10.1186/s12883-020-01637-z
pii: 10.1186/s12883-020-01637-z
pmc: PMC7017529
doi:
Types de publication
Case Reports
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
55Subventions
Organisme : Medizinische Fakultät, Universität Duisburg-Essen
ID : D/107-40960
Références
Muscle Nerve. 2011 Oct;44(4):593-6
pubmed: 21922473
J Neurosurg Pediatr. 2010 Nov;6(5):506-10
pubmed: 21039177
Neurosurgery. 1998 Jul;43(1):78-83
pubmed: 9657192
J Child Neurol. 2004 Jan;19(1):71-5
pubmed: 15032391
Childs Nerv Syst. 2016 Aug;32(8):1555-60
pubmed: 27086131
J Hand Surg Br. 2001 Apr;26(2):168-70
pubmed: 11281674
Neurology. 2017 Mar 7;88(10):e85-e86
pubmed: 28265045
Ann Intern Med. 2009 Aug 18;151(4):264-9, W64
pubmed: 19622511
Am J Surg Pathol. 2018 Dec;42(12):1708-1714
pubmed: 30303818
Neurosurg Focus. 2015 Sep;39(3):E13
pubmed: 26323815
J Hand Surg Eur Vol. 2008 Feb;33(1):88-9
pubmed: 18332033
Arch Pathol Lab Med. 2007 Apr;131(4):625-36
pubmed: 17425397
Radiol Case Rep. 2015 Dec 07;7(1):649
pubmed: 27326273
Muscle Nerve. 1999 Jan;22(1):28-36
pubmed: 9883854
Acta Neuropathol. 2012 Mar;123(3):295-319
pubmed: 22327363
Neurosurgery. 2019 Dec 1;85(6):786-792
pubmed: 30481319
Arch Pathol Lab Med. 2007 Sep;131(9):1382-92
pubmed: 17824794
Neurosurg Focus. 2007 Jun 15;22(6):E23
pubmed: 17613215
Am J Surg Pathol. 1988 Sep;12(9):678-83
pubmed: 3046395
J Neurosurg. 2018 Oct;129(4):1034-1040
pubmed: 29192862
Muscle Nerve. 2004 Aug;30(2):239-43
pubmed: 15266642
Hand (N Y). 2010 Sep;5(3):286-93
pubmed: 19876692
J Neurosurg. 2001 May;94(5):811-5
pubmed: 11354415
J Neuroimaging. 2015 Jul-Aug;25(4):528-38
pubmed: 25996962
Science. 1966 Dec 16;154(3755):1464-7
pubmed: 5921613
Muscle Nerve. 1991 Apr;14(4):335-41
pubmed: 1851247
Arch Plast Surg. 2014 May;41(3):296-9
pubmed: 24883285
Ann Neurol. 2017 Feb;81(2):316-321
pubmed: 28019650
Zentralbl Neurochir. 2008 Aug;69(3):134-8
pubmed: 18666052
Brain. 2009 Aug;132(Pt 8):2265-76
pubmed: 19567701
Plast Reconstr Surg. 1988 Feb;81(2):251-8
pubmed: 3336657
Am J Clin Pathol. 1995 Jun;103(6):696-704
pubmed: 7785653
Am J Surg Pathol. 1997 Feb;21(2):164-73
pubmed: 9042282
Plast Reconstr Surg. 2000 May;105(6):2089-91
pubmed: 10839408
Muscle Nerve. 2007 Nov;36(5):715-20
pubmed: 17471567
Clin Case Rep. 2016 Jul 06;4(8):777-81
pubmed: 27525083
Neurosurg Focus. 2009 Feb;26(2):E12
pubmed: 19416056
J Hand Surg Am. 2005 Jul;30(4):820-5
pubmed: 16039379