title: Multinodular/plexiform (multifascicular) schwannomas of major peripheral nerves: an underrecognized part of the spectrum of schwannomas.
abstract: OBJECTIVE
  In clinical practice, schwannomas are among the most common types of nerve sheath tumors. Their clinical presentation, imaging characteristics, and operative features are well known. Over the past 20 years, clinical outcomes have improved due to resection of these tumors at a fascicular level. Despite these advances, a subgroup of patients with schwannomas is associated with a disappointing neurological outcome following resection. The purpose of this study was to correlate the imaging and histological features in this group of patients with more anatomically complex forms of schwannomas.
  
  
  METHODS
  In a retrospective review performed at their institution over a 10-year period, the authors found a subgroup of patients with complex multinodular/plexiform schwannomas affecting major peripheral nerves. Eleven patients were identified, and the clinical, imaging, and pathological features of their disease were reviewed.
  
  
  RESULTS
  The clinical presentation of multinodular/plexiform schwannomas of major peripheral nerves may be similar to that of conventional schwannomas, but their imaging features, operative appearance, and outcomes differ.
  
  
  CONCLUSIONS
  Preoperatively and intraoperatively, the distinguishing features of multinodular/plexiform schwannomas of major peripheral nerves may be subtle and can easily go unrecognized, thus explaining the often suboptimal surgical results. Familiarity with the imaging and operative features of multinodular/plexiform schwannomas will no doubt alter treatment approaches and improve neurological function in this subgroup of patients.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Marie-Noëlle
authors.initials: MN
authors.lastname: Hébert-Blouin
authors.forename: Kimberly K
authors.initials: KK
authors.lastname: Amrami
authors.forename: Bernd W
authors.initials: BW
authors.lastname: Scheithauer
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Spinner
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D010525:Peripheral Nerves / Q000473:pathology / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome