title: Brachial plexus tumors in a tertiary referral center: a case series and literature review.
abstract: BACKGROUND
  Brachial plexus (BP) tumors are very rare tumors, with less than 800 cases been described in the literature worldwide since 1970. These tumors often present as local or radicular pain, with scant or no neurological deficits. These symptoms are shared by many other more common rheumatologic diseases, thus making their diagnosis difficult in most cases. Additionally, these tumors often present as lumps and are therefore biopsied, which carries a significant risk of iatrogenic nerve injury.
  
  
  METHODS
  In this paper the authors describe their experience with the management of 5 patients with BP tumors followed up for at least 2 years. There were 4 males and 1 female. Median follow-up time was 41 ± 21 months. Average age at diagnosis was 40,0 ± 19,9 years. The most common complaints at presentation were pain and sensibility changes. All patients had a positive Tinel sign when the lesion was percussed. In all patients surgery was undertaken and the tumors removed. In 4 patients nerve integrity was maintained. In one patient with excruciating pain a segment of the nerve had to be excised and the nerve defect was bridged with sural nerve grafts.
  
  
  RESULTS
  Pathology examination of the resected specimens revealed a Schwannoma in 4 cases and a neurofibroma in the patient submitted to segmental nerve resection. Two years postoperatively, no recurrences were observed. All patients revealed clinical improvement. The patient submitted to nerve resection had improvement in pain, but presented diminished strength and sensibility in the involved nerve territory.
  
  
  CONCLUSIONS
  Surgical excision of BP tumors is not a risk free procedure. Most authors suggest surgery if the lesion is symptomatic or progressing in size. If the tumor is stationary and not associated with neurological dysfunction a conservative approach should be taken.
authors.forename: G
authors.initials: G
authors.lastname: Millan
authors.forename: D
authors.initials: D
authors.lastname: Casal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001917:Brachial Plexus; D020516:Brachial Plexus Neuropathies / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010524:Peripheral Nervous System Neoplasms / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D055815:Young Adult