title: Benign solitary schwannomas: a review of 234 cases.
abstract: We reviewed 234 benign solitary schwannomas treated between 1984 and 2004. The mean age of the patients was 45.2 years (11 to 82). There were 170 tumours (73%) in the upper limb, of which 94 (40%) arose from the brachial plexus or other nerves within the posterior triangle of the neck. Six (2.6%) were located within muscle or bone. Four patients (1.7%) presented with tetraparesis due to an intraspinal extension. There were 198 primary referrals (19 of whom had a needle biopsy in the referring unit) and in these patients the tumour was excised. After having surgery or an open biopsy at another hospital, a further 36 patients were seen because of increased neurological deficit, pain or incomplete excision. In these, a nerve repair was performed in 18 and treatment for pain or paralysis was offered to another 14. A tender mass was found in 194 (98%) of the primary referrals. A Tinel-like sign was recorded in 155 (81%). Persistent spontaneous pain occurred in 60 (31%) of the 194 with tender mass, impairment of cutaneous sensibility in 39 (20%), and muscle weakness in 24 (12%). After apparently adequate excision, two tumours recurred. No case of malignant transformation was seen.
authors.affiliation: Department of Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. dmaknight@rcsed.ac.uk
authors.forename: D M A
authors.initials: DM
authors.lastname: Knight
authors.forename: R
authors.initials: R
authors.lastname: Birch
authors.forename: J
authors.initials: J
authors.lastname: Pringle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001859:Bone Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D020516:Brachial Plexus Neuropathies / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D009442:Neurilemmoma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010146:Pain / Q000503:physiopathology; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D016896:Treatment Outcome