Abstract
Magnetic resonance imaging (MRI) was used to evaluate 22 histologically proven peripheral nerve sheath tumors, approximately two-thirds of which arose in the lower extremity. The histologic distribution was as follows: 12 schwannomas, 7 neurofibromas, and 3 malignant peripheral nerve sheath tumors (2 of which occurred in patients with neurofibromatosis). Most lesions demonstrated an intermediate to moderately bright signal on T1-weighted images and were minimally inhomogeneous. All lesions were moderately bright on proton-density-weighted images and bright on T2-weighted images, again with variable inhomogeneity. The extent of the tumor was best assessed on proton-density- and T2-weighted images. Smooth margins were noted in 19 lesions. Of the 3 remaining lesions, 2 were malignant (but had been subjected to biopsy prior to MRI), and the other lesion was a plexiform neurofibroma. MRI accurately determined the relationship between the lesion and the adjacent neurovascular structures and muscles, thereby assisting surgical management. On MRI, 5 lesions demonstrated coexistent subtle muscle atrophy along the longitudinal axis of surrounding or distally innervated musculature. This latter finding, together with the presence of a tumor in the vicinity of a large nerve trunk, suggests a peripheral nerve sheath neoplasm.
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Aisen AM, Martel W, Braunstein EM, McMillin KI, Phillips WA, Kling TF (1986) MRI and CT evaluation of primary bone and soft-tissue tumors. AJR 146:749
Cohen LM, Schwartz AM, Rockoff SD (1986) Benign schwannomas: pathologic basis for CT inhomogeneities. AJR 147:141
Chui MC, Bird BL, Rogers J (1988) Extracranial and extraspinal nerve sheath tumors: computed tomographic evaluation. Neuroradiology 30:47
Das Gupta TK, Brasfield RD (1970) Solitary malignant schwannoma. Ann Surg 171:419
Das Gupta TK, Brasfield RD (1970) Tumors of peripheral nerve origin: benign and malignant solitary schwannomas. CA 20:228
Das Gupta TK, Brasfield RD, Strong EW, Hajdu SI (1969) Benign solitary schwannomas (neurilemomas). Cancer 24:355
Ducatman BS, Scheithauer BW, Piepgras DG, Reiman HM, Ilstrup DM (1986) Malignant peripheral nerve sheath tumors: a clinicopathologic study of 120 cases. Cancer 57:2006
Enzinger FM, Weiss SW (1988) Soft tissue tumors. Mosby, St. Louis, p 719
Fornage BD (1988) Peripheral nerves of the extremeties: imaging with US. Radiology 167:179
Jenkins SA (1952) Solitary tumors of peripheral nerve trunks. J Bone Joint Surg [Br] 34:401
Kilcoyne RF, Richardson ML, Porter BA, Olson DO, Greenlee TK, Lanzer W (1988) Magnetic resonance imaging of soft tissue masses. Clin Orthop 228:13
Kransdorf MJ, Jelinek JS, Moser RP, Utz JA, Brower AC, Hudson TM, Berrey BH (1989) Soft-tissue masses: diagnosis using MR imaging. AJR 153:541
Levine E, Huntrakoon M, Wetzel LH (1987) Malignant nerve-sheath neoplasms in neurofibromatosis: distinction from benign tumors by using imaging techniques. AJR 149:1059
Marmor L (1965) Solitary peripheral nerve tumors. Clin Orthop 43:183
Petasnick JP, Turner DA, Charters JR, Gitelis S, Zacharias CE (1986) Soft tissue masses of the locomotor system: comparison of MR imaging with CT. Radiology 160:125
Powers SK, Norman D, Edwards MSB (1983) Computerized tomography of peripheral nerve lesions. J Neurosurg 59:131
Resnick D, Niwayama G (1988) Diagnosis of bone and joint disorders, 2nd edn. WB Saunders, Philadelphia, p 4218
Rigamonti D, Spetzler RI, Shetter A (1987) Magnetic resonance imaging and trigeminal schwannoma. Surg Neurol 28:67
Stout AP (1935) The peripheral manifestations of the specific nerve sheath tumor (neurilemoma). Am J Cancer 24(4): 751
Sundaram M, McGuire MH, Herbold DR (1988) Magnetic resonance imaging of soft tissue masses: an evaluation of fifty-three histologically proven tumors. Mag Res Imag 6:237
Totty WG, Murphy WA, Lee JKT (1986) Soft-tissue tumors: MR imaging. Radiology 160:135
Vieta JO, Pack GT (1951) Malignant neurilemomas of peripheral nerves. Am J Surg 82:416
White HR (1971) Survival in malignant schwannoma: an 18-year study. Cancer 27:720
White NB (1967) Neurilemomas of the extremities. J Bone Joint Surg [Am] 49:1605
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The opinions and assertions contained herein are the private views of the authors and do not reflect the views of the Uniformed Services University of the Health Sciences, the Department of the Army, or of the Department of Defense
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Stull, M.A., Moser, R.P., Kransdorf, M.J. et al. Magnetic resonance appearance of peripheral nerve sheath tumors. Skeletal Radiol. 20, 9–14 (1991). https://doi.org/10.1007/BF00243714
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DOI: https://doi.org/10.1007/BF00243714