Brachial plexus tumors extending into the cervicothoracic spine: a review with operative nuances and outcomes.
Neurofibroma
Peripheral nerve
Scapula
Schwannoma
Subscapular
Supraclavicular
Journal
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico
ISSN: 1699-3055
Titre abrégé: Clin Transl Oncol
Pays: Italy
ID NLM: 101247119
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
26
10
2020
accepted:
27
12
2020
pubmed:
16
1
2021
medline:
24
12
2021
entrez:
15
1
2021
Statut:
ppublish
Résumé
The rarity and anatomical complexity of brachial plexus tumors (BPTs) impose many challenges onto surgeons performing surgical resections, especially when these tumors invade the cervicothoracic spine. Treatment choices and surgery outcomes heavily depend on anatomical location and tumor type. The authors performed an extensive review of the published literature (PubMed) focusing on "brachial plexus tumors" that identified invasion of the cervicothoracic spine. The search yielded 2774 articles pertaining to "brachial plexus tumors". Articles not in the English language or involving cervicothoracic spinal invasion were excluded. Recent research has shown that the most common method used to resect tumors of the proximal roots is the dorsal subscapular approach. Despite its association with high morbidity rate, this technique offers excellent exposure to the spinal roots and intraforaminal portion of the spinal nerve. The dorsal approach is used to resect recurrent lower trunk tumors and dumbbell-shaped neurofibromas, yet it is also the least common overall approach used in brachial plexus tumor resections. The ventral or anterior technique is commonly used to resect tumors at the cord to division level, and root to trunk level. Motor complications, transient nerve palsy, and bleeding are among the most common complications of the anterior supraclavicular approach. Further controlled studies are needed to fully determine the optimal surgical approach used to obtain the best outcomes and least complications for each type of brachial plexus tumor.
Sections du résumé
BACKGROUND
BACKGROUND
The rarity and anatomical complexity of brachial plexus tumors (BPTs) impose many challenges onto surgeons performing surgical resections, especially when these tumors invade the cervicothoracic spine. Treatment choices and surgery outcomes heavily depend on anatomical location and tumor type.
METHODS
METHODS
The authors performed an extensive review of the published literature (PubMed) focusing on "brachial plexus tumors" that identified invasion of the cervicothoracic spine.
RESULTS
RESULTS
The search yielded 2774 articles pertaining to "brachial plexus tumors". Articles not in the English language or involving cervicothoracic spinal invasion were excluded.
CONCLUSIONS
CONCLUSIONS
Recent research has shown that the most common method used to resect tumors of the proximal roots is the dorsal subscapular approach. Despite its association with high morbidity rate, this technique offers excellent exposure to the spinal roots and intraforaminal portion of the spinal nerve. The dorsal approach is used to resect recurrent lower trunk tumors and dumbbell-shaped neurofibromas, yet it is also the least common overall approach used in brachial plexus tumor resections. The ventral or anterior technique is commonly used to resect tumors at the cord to division level, and root to trunk level. Motor complications, transient nerve palsy, and bleeding are among the most common complications of the anterior supraclavicular approach. Further controlled studies are needed to fully determine the optimal surgical approach used to obtain the best outcomes and least complications for each type of brachial plexus tumor.
Identifiants
pubmed: 33449268
doi: 10.1007/s12094-020-02549-7
pii: 10.1007/s12094-020-02549-7
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1263-1271Références
Binder DK, Smith JS, Barbaro NM. Primary brachial plexus tumors: imaging, surgical, and pathological findings in 25 patients. Neurosurg Focus. 2004;16:1–6. https://doi.org/10.3171/foc.2004.16.5.12 .
doi: 10.3171/foc.2004.16.5.12
Crutcher CL 2nd, Kline DG, Tender GC. A modified, less invasive posterior subscapular approach to the brachial plexus: case report and technical note. Neurosurg Focus. 2017;42:E7. https://doi.org/10.3171/2016.12.FOCUS16470 .
doi: 10.3171/2016.12.FOCUS16470
pubmed: 28245672
Das S, Ganju A, Tiel RL, Kline DG. Tumors of the brachial plexus. Neurosurg Focus. 2007;22:1–6. https://doi.org/10.3171/foc.2007.22.6.27 .
doi: 10.3171/foc.2007.22.6.27
Desai KI. Primary benign brachial plexus tumors. Neurosurgery. 2012;70:220–33. https://doi.org/10.1227/NEU.0b013e31822d276a .
doi: 10.1227/NEU.0b013e31822d276a
pubmed: 21795865
Dubuisson AS, Kline DG, Weinshel SS. Posterior subscapular approach to the brachial plexus. J Neurosurg. 1993;79:319–30. https://doi.org/10.3171/jns.1993.79.3.0319 .
doi: 10.3171/jns.1993.79.3.0319
pubmed: 8360726
Ganju A, Roosen N, Kline DG, Tiel RL. Outcomes in a consecutive series of 111 surgically treated plexal tumors: a review of the experience at the Louisiana State University Health Sciences Center. J Neurosurg. 2001;95:51–60. https://doi.org/10.3171/jns.2001.95.1.0051 .
doi: 10.3171/jns.2001.95.1.0051
pubmed: 11453398
Garcia CA, Kline DG, Lusk MD. Tumors of the brachial plexus. Neurosurgery. 1987;21:439–53. https://doi.org/10.1227/00006123-198710000-00001 .
doi: 10.1227/00006123-198710000-00001
pubmed: 3317105
Go MH, Kim SH, Cho KH. Brachial plexus tumors in a consecutive series of twenty one patients. J Korean Neurosurg Soc. 2012. https://doi.org/10.3340/jkns.2012.52.2.138 .
doi: 10.3340/jkns.2012.52.2.138
pubmed: 23091673
pmcid: 3467372
Graf A, Yang K, King D, Dzwierzynski W, Sanger J, Hettinger P. Lipomas of the brachial plexus: a case series and review of the literature. Hand. 2017;14:333–8. https://doi.org/10.1177/1558944717735946 .
doi: 10.1177/1558944717735946
pubmed: 29058949
Gwathmey KG. Plexus and peripheral nerve metastasis. Handbook of clinical neurology, vol. 149. Amsterdam: Elsevier; 2018. https://doi.org/10.1016/B978-0-12-811161-1.00017-7 .
doi: 10.1016/B978-0-12-811161-1.00017-7
Huang JH, Samadani U, Zager EL. Brachial plexus region tumors: a review of their history, classification, surgical management, and outcomes. Neurosurg Q. 2003;13:151–61. https://doi.org/10.1097/00013414-200309000-00001 .
doi: 10.1097/00013414-200309000-00001
Huang JH, Zaghloul K, Zager EL. Surgical management of brachial plexus region tumors. Surg Neurol. 2004;61:372–8. https://doi.org/10.1016/j.surneu.2003.08.006 .
doi: 10.1016/j.surneu.2003.08.006
pubmed: 15031078
Jaeckle KA. Nerve plexus metastases. Neurol Clin. 1991;9:857–66.
doi: 10.1016/S0733-8619(18)30253-6
Jaeckle KA. Neurologic manifestations of neoplastic and radiation-induced plexopathies. Semin Neurol. 2010. https://doi.org/10.1055/s-0030-1255219 .
doi: 10.1055/s-0030-1255219
pubmed: 20577932
Jia X, Yang J, Chen L, Yu C, Kondo T. Primary brachial plexus tumors: clinical experiences of 143 cases. Clin Neurol Neurosurg. 2016;148:91–5. https://doi.org/10.1016/j.clineuro.2016.07.009 .
doi: 10.1016/j.clineuro.2016.07.009
pubmed: 27428490
Jung IH, Yoon KW, Kim YJ, Lee SK. Analysis according to characteristics of 18 cases of brachial plexus tumors: a review of surgical treatment experience. J Korean Neurosurg Soc. 2018;61:625–32. https://doi.org/10.3340/jkns.2018.0045 .
doi: 10.3340/jkns.2018.0045
pubmed: 30196660
pmcid: 6129745
Kim DH, Cho Y-J, Tiel RL, Kline DG. Outcomes of surgery in 1019 brachial plexus lesions treated at Louisiana State University Health Sciences Center. J Neurosurg. 2003;98:1005–16. https://doi.org/10.3171/jns.2003.98.5.1005 .
doi: 10.3171/jns.2003.98.5.1005
pubmed: 12744360
Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg. 2005;102:246–55. https://doi.org/10.3171/jns.2005.102.2.0246 .
doi: 10.3171/jns.2005.102.2.0246
pubmed: 15739552
Kimura M, Kamata Y, Matsumoto K, Takaya H. Electron microscopical study on the tumor of von Recklinghausen’s neurofibromatosis. Acta Pathol Jpn. 1974;24:79–91. https://doi.org/10.1111/j.1440-1827.1974.tb00809.x .
doi: 10.1111/j.1440-1827.1974.tb00809.x
pubmed: 4207546
Kindl RP, Patel K, Trivedi RA. Supraclavicular brachial plexus approach for excision of C8 nerve root schwannoma: 3-dimensional operative video. Oper Neurosurg (Hagerstown). 2019;16:634–5. https://doi.org/10.1093/ons/opy209 .
doi: 10.1093/ons/opy209
Kindl RP, Patel K, Trivedi RA. Supraclavicular brachial plexus approach for excision of C8 nerve root schwannoma: 3-dimensional operative video. Oper Neurosurg. 2019;16:634–5. https://doi.org/10.1093/ons/opy209 .
doi: 10.1093/ons/opy209
Kline D, Hudson A, Tiel R, Guha A. Management of peripheral nerve tumors. In: Winn H, Winn H, editors. Youmans neurological surgery, 4-volume set. 6th ed. Philadelphia: Saunders; 2011. p. 4960.
Kline DG, Donner TR, Happel L, Smith B, Richter HP. Intraforaminal repair of plexus spinal nerves by a posterior approach: an experimental study. J Neurosurg. 1992;76:459–70. https://doi.org/10.3171/jns.1992.76.3.0459 .
doi: 10.3171/jns.1992.76.3.0459
pubmed: 1738028
Kline DG, Judice DJ. Operative management of selected brachial plexus lesions. J Neurosurg. 1983;58:631–49. https://doi.org/10.3171/jns.1983.58.5.0631 .
doi: 10.3171/jns.1983.58.5.0631
pubmed: 6834110
Koga T, Iwasaki H, Ishiguro M, Matsuzaki A, Kikuchi M. Frequent genomic imbalances in chromosomes 17, 19, and 22q in peripheral nerve sheath tumours detected by comparative genomic hybridization analysis. J Pathol. 2002;197:98–107. https://doi.org/10.1002/path.1101 .
doi: 10.1002/path.1101
pubmed: 12081210
Kori SH, Foley KM, Posner JB. Brachial plexus lesions in patients with cancer: 100 cases. Neurology. 1981;31:45–50. https://doi.org/10.1212/wnl.31.1.45 .
doi: 10.1212/wnl.31.1.45
pubmed: 6256684
Lee HJ, Kim JH, Rhee SH, Gong HS, Baek GH. Is surgery for brachial plexus schwannomas safe and effective? Clin Orthop Relat Res. 2014;472:1893–8. https://doi.org/10.1007/s11999-014-3525-x .
doi: 10.1007/s11999-014-3525-x
pubmed: 24562874
pmcid: 4016461
Lee HJ, Kim JH, Rhee SH, Gong HS, Baek GH. Is surgery for brachial plexus schwannomas safe and effective? Clin Orthop Relat Res®. 2014;472:1893–8. https://doi.org/10.1007/s11999-014-3525-x .
doi: 10.1007/s11999-014-3525-x
Lee MH, Park HK, Park HR, Park SQ, Chang JC, Cho SJ. Brachial plexus neurofibroma: a case report. Nerve. 2020;6:12–4. https://doi.org/10.21129/nerve.2020.6.1.12 .
doi: 10.21129/nerve.2020.6.1.12
Lutz AM, Gold G, Beaulieu C. MR imaging of the brachial plexus. Neuroimaging Clin N Am. 2014;24:91–108. https://doi.org/10.1016/j.nic.2013.03.024 .
doi: 10.1016/j.nic.2013.03.024
pubmed: 24210315
Lwu S, Midha R. Clinical examination of brachial and pelvic plexus tumors. Neurosurg Focus. 2007;22:E5. https://doi.org/10.3171/foc.2007.22.6.6 .
doi: 10.3171/foc.2007.22.6.6
pubmed: 17613222
Murovic JA, Charles Cho S, Park J. Surgical strategies for managing foraminal nerve sheath tumors: the emerging role of CyberKnife ablation. Eur Spine J. 2010;19:242–56. https://doi.org/10.1007/s00586-009-1160-0 .
doi: 10.1007/s00586-009-1160-0
pubmed: 19798517
Richardson RR, Siqueira EB, Oi S, Nunez C. Neurogenic tumors of the brachial plexus. Neurosurgery. 1979;4:66–70. https://doi.org/10.1227/00006123-197901000-00014 .
doi: 10.1227/00006123-197901000-00014
pubmed: 450220
Rosario MS, Yamamoto N, Hayashi K, Takeuchi A, Miwa S, Inatani H, Higuchi T, Tsuchiya H. A case of infected schwannoma mimicking malignant tumor. World J Surg Oncol. 2016. https://doi.org/10.1186/s12957-016-1058-3 .
doi: 10.1186/s12957-016-1058-3
pubmed: 27923374
pmcid: 5141643
Saifuddin A. Imaging tumours of the brachial plexus. Skelet Radiol. 2003;32:375–87. https://doi.org/10.1007/s00256-003-0618-0 .
doi: 10.1007/s00256-003-0618-0
Siqueira MG, Martins RS, Teixeira MJ. Management of brachial plexus region tumours and tumour-like conditions: relevant diagnostic and surgical features in a consecutive series of eighteen patients. Acta Neurochir. 2009;151:1089–98. https://doi.org/10.1007/s00701-009-0380-8 .
doi: 10.1007/s00701-009-0380-8
pubmed: 19448970
Tender GC, Kline DG. Anterior supraclavicular approach to the brachial plexus. Neurosurgery. 2006. https://doi.org/10.1227/01.NEU.0000209027.52848.A3 ((discussion ONS-364–365)).
doi: 10.1227/01.NEU.0000209027.52848.A3
pubmed: 16582661
Tschoe C, Holsapple JW, Binello E. Resection of primary brachial plexus tumor via a modified supraclavicular approach. J Neurol Surg Rep. 2014;75:133–5. https://doi.org/10.1055/s-0034-1376423 .
doi: 10.1055/s-0034-1376423
Vucemilo L, Lajtman Z, Mihalj J, Plascak J, Mahovic Lakusic D, Muzinic D. Brachial plexus schwannoma—case report and literature review. Acta Clin Croat. 2018;57:366–71. https://doi.org/10.20471/acc.2018.57.02.19 .
doi: 10.20471/acc.2018.57.02.19
pubmed: 30431732
pmcid: 6532008