Materiały źródłowe

• #1 Benign peripheral nerve sheath tumors: an interdisciplinary diagnostic and therapeutic challenge

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10439084/

  A benign peripheral nerve sheath tumor (bPNST) is a rare lesion associated with peripheral nerval structures. Symptoms may be heterogeneous, complicating diagnosis finding. […] Therefore, we analyzed patients treated for bPNST in our specialized institution with a primary focus on prior misdiagnosis and possible mistreatment. […] An incorrect primary diagnosis was detected in 44.7% (n=38), leading to suboptimal or insufficient treatment in these cases. […] For the first time, our data shows the quantity and impact of incorrect initial diagnosis in bPNST causing a delay in causative treatment or resulting in unnecessary or potentially harmful treatment. […] Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing.

• #2 Benign peripheral nerve sheath tumors: an interdisciplinary diagnostic and therapeutic challenge

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10439084/

  However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients. […] Misdiagnosis and mistreatment showed a significant correlation with the treating specialist. […] Furthermore, patients receiving MRI of the cervical spine or the lumbar spine as an initial diagnostic tool showed significantly higher rates of misdiagnosis and mistreatment in comparison to patients receiving MRI of another area, which was usually the tumor-bearing region.

• #3

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  A benign peripheral nerve sheath tumor (bPNST) is a rare lesion associated with peripheral nerval structures. Symptoms may be heterogeneous, complicating diagnosis finding. […] Therefore, we analyzed patients treated for bPNST in our specialized institution with a primary focus on prior misdiagnosis and possible mistreatment. […] Assessment of demographics, tumor entity, tumor location, symptoms, the interval between the onset of symptoms and surgery, involved medical specialties, and outpatients treatment, with particular focus on initial misdiagnosis and inappropriate medical treatment, was performed. […] An incorrect primary diagnosis was detected in 44.7% (n=38), leading to suboptimal or insufficient treatment in these cases. […] For the first time, our data shows the quantity and impact of incorrect initial diagnosis in bPNST causing a delay in causative treatment or resulting in unnecessary or potentially harmful treatment.

• #4 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #5 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  Benign peripheral nerve tumors are tumors that form on peripheral nerves. The peripheral nerves link the brain and spinal cord to other parts of the body. These nerves control muscles that allow you to walk, blink, swallow, pick things up and do other activities. Benign tumors are not cancerous. […] It’s important to see your healthcare professional if you have a lump or if you have pain, tingling, numbness or muscle weakness. […] To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve.

• #6 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #7 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  To diagnose a peripheral nerve tumor, your health care provider will ask about your symptoms and medical history. You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms. […] Magnetic resonance imaging (MRI). This scan uses a magnet and radio waves to produce a detailed 3D view of nerves and tissue. […] Computerized tomography (CT). A CT scanner rotates around the body to take a series of images. A computer uses the image to make a detailed view of the peripheral nerve tumor. A CT scan can help your provider determine how the tumor may be affecting you. […] Electromyogram (EMG). For this test, small needles are placed in the muscles. An instrument records the electrical activity in the muscle as they’re moved. […] Nerve conduction study. This test is often done with an EMG. It measures how fast the nerves carry electrical signals to the muscles.

• #8 Diagnosis and Treatment of Peripheral and Cranial Nerve Tumors with Expert Recommendations: An EUropean Network for RAre CANcers (EURACAN) Initiative

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10093509/

  The 2021 WHO classification of the CNS Tumors identifies as Peripheral nerve sheath tumors (PNST) some entities with specific clinical and anatomical characteristics, histological and molecular markers, imaging findings, and aggressiveness. […] Tumor diagnosis is primarily based on hematoxylin and eosin-stained sections and immunohistochemistry. […] MRI is the gold-standard to delineate the extension with respect to adjacent structures. […] Gross-total resection is the first choice, and can be curative in benign lesions; however, the extent of resection must be balanced with preservation of nerve functioning. […] Radiotherapy can be omitted in benign tumors after complete resection and in NF-related tumors, due to the theoretic risk of secondary malignancies in a tumor-suppressor syndrome. […] Systemic therapy should be considered in incomplete resected plexiform neurofibromas/MPNSTs. […] Clinical trials on other MEK1-2 inhibitors alone or in combination with mTOR inhibitors are under investigation in plexiform neurofibromas and MPNST, respectively.

• #9 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #10 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved. […] Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #11 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Positron emission tomography (PET) is a nuclear medicine study that creates multidimensional color images that reveal how a mass may be functioning relative to surrounding normal tissue by tracing levels of chemical uptake; can be combined with MRI or CT scans and is most useful in differentiating benign from malignant tumors. […] Electromyogram and nerve conduction studies (EMG/NCS) measure how effectively a nerve is relaying electrical impulses; detect the location and extent of damage in nerves and muscles […] Ultrasound is a noninvasive test using sound waves to reveal a quick image of a mass deep to the skin and surrounding structures; can tell whether a mass is solid or fluid-filled, and what approximate size it is. […] Based on these imaging results, a biopsy may be required to take a small sample of tissue from the suspected tumor and sent to a pathology lab for further analysis before deciding next steps.

• #12 Surgical outcome of isolated benign peripheral nerve sheath tumors without neurofibromatosis | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-024-00297-2

  Benign peripheral nerve sheath tumors (BPNSTs) include schwannomas and neurofibromas. […] Surgical resection remains the treatment of choice of BPNSTs because they may cause neural compromise, rapid growth, and pressure they apply to nearby structures. […] However, to diagnose a symptomatic PNSTs we depend on clinical examination, ultrasound, and MRI scan. […] A precise diagnosis is crucial for the treatment of any tumor. […] MRI proved to be very useful for us. […] Ultrasonography became more refined and can help with better diagnosis. […] Schwannomas grow outside the nerve bundles from which they originate, but neurofibromas are mixed with many nerve bundles and are harder to remove completely, regardless of how easy they are to reach. […] Nerve trunks in the limbs can be clinically diagnosed easily and the optimal treatment is to excise the tumor while maintaining nerve function. […] Benign peripheral nerve sheath tumors are safely resected without increased sensory and motor deficits after surgery and with improved clinical outcome with no recurrence on follow up.

• #13 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Positron emission tomography (PET) is a nuclear medicine study that creates multidimensional color images that reveal how a mass may be functioning relative to surrounding normal tissue by tracing levels of chemical uptake; can be combined with MRI or CT scans and is most useful in differentiating benign from malignant tumors. […] Electromyogram and nerve conduction studies (EMG/NCS) measure how effectively a nerve is relaying electrical impulses; detect the location and extent of damage in nerves and muscles […] Ultrasound is a noninvasive test using sound waves to reveal a quick image of a mass deep to the skin and surrounding structures; can tell whether a mass is solid or fluid-filled, and what approximate size it is. […] Based on these imaging results, a biopsy may be required to take a small sample of tissue from the suspected tumor and sent to a pathology lab for further analysis before deciding next steps.

• #14

  https://link.springer.com/article/10.1007/s40336-024-00669-6

  Malignant peripheral nerve sheath tumors (MPNSTs) are rare tumors that show high metastatic potential and have a poor prognosis. [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is helpful for diagnosing MPNSTs, but the ideal parameters and threshold values remain unclear. The purpose of our study was to evaluate visual assessment and quantitative analysis of [18F]FDG PET/CT for differentiating between benign peripheral nerve sheath tumors (BPNSTs) and MPNSTs. […] Among the visual parameters, uptake intensity greater than liver (P=0.001) and heterogenous uptake (P=0.004) were significant parameters for diagnosing MPNSTs. All of the quantitative parameters analysed were significant for diagnosing MPNSTs, with SUVmax showing the largest area under the curve (AUC) of 0.87 (P0.001) with an optimal threshold of 6.9 (sensitivity 76.8% and specificity 87.2%). In addition, the SUVmax of high-grade MPNSTs were significantly higher than those of low-grade MPNSTs (P=0.039). […] Of the [18F]FDG PET/CT measures investigated, SUVmax showed the highest accuracy for diagnosing MPNSTs, and also showed an association with the grade of MPNSTs.

• #15 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #16 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  To diagnose a peripheral nerve tumor, your health care provider will ask about your symptoms and medical history. You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms. […] Magnetic resonance imaging (MRI). This scan uses a magnet and radio waves to produce a detailed 3D view of nerves and tissue. […] Computerized tomography (CT). A CT scanner rotates around the body to take a series of images. A computer uses the image to make a detailed view of the peripheral nerve tumor. A CT scan can help your provider determine how the tumor may be affecting you. […] Electromyogram (EMG). For this test, small needles are placed in the muscles. An instrument records the electrical activity in the muscle as they’re moved. […] Nerve conduction study. This test is often done with an EMG. It measures how fast the nerves carry electrical signals to the muscles.

• #17 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #18 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved. […] Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #19 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. Depending on the tumor’s size and location, you might need local or general anesthesia during the biopsy. The biopsy might be done with a needle with the help of imaging, or it might be done during surgery. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #20 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  To diagnose a peripheral nerve tumor, your health care provider will ask about your symptoms and medical history. You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms. […] Magnetic resonance imaging (MRI). This scan uses a magnet and radio waves to produce a detailed 3D view of nerves and tissue. […] Computerized tomography (CT). A CT scanner rotates around the body to take a series of images. A computer uses the image to make a detailed view of the peripheral nerve tumor. A CT scan can help your provider determine how the tumor may be affecting you. […] Electromyogram (EMG). For this test, small needles are placed in the muscles. An instrument records the electrical activity in the muscle as they’re moved. […] Nerve conduction study. This test is often done with an EMG. It measures how fast the nerves carry electrical signals to the muscles.

• #21 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. Depending on the tumor’s size and location, you might need local or general anesthesia during the biopsy. The biopsy might be done with a needle with the help of imaging, or it might be done during surgery. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #22 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  Tumor biopsy. If you have a nerve tumor, you may need a biopsy. A small sample of cells from the tumor is removed and analyzed. Depending on the tumor’s size and location, you may need to have medicine that numbs an area of the body, called local anesthesia, or medicine that puts you to sleep, called general anesthesia, during the biopsy. Sometimes a biopsy is the only way to determine whether a tumor is cancerous. […] Nerve biopsy. A biopsy of the nerve may be needed in people who have certain conditions, such as progressive peripheral neuropathy and enlarged nerves that mimic nerve tumors. […] Peripheral nerve tumors aren’t common. It’s important to find a provider who is experienced in diagnosing and treating them. If needed, seek a second opinion.

• #23 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. Depending on the tumor’s size and location, you might need local or general anesthesia during the biopsy. The biopsy might be done with a needle with the help of imaging, or it might be done during surgery. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #24 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  Tumor biopsy. If you have a nerve tumor, you may need a biopsy. A small sample of cells from the tumor is removed and analyzed. Depending on the tumor’s size and location, you may need to have medicine that numbs an area of the body, called local anesthesia, or medicine that puts you to sleep, called general anesthesia, during the biopsy. Sometimes a biopsy is the only way to determine whether a tumor is cancerous. […] Nerve biopsy. A biopsy of the nerve may be needed in people who have certain conditions, such as progressive peripheral neuropathy and enlarged nerves that mimic nerve tumors. […] Peripheral nerve tumors aren’t common. It’s important to find a provider who is experienced in diagnosing and treating them. If needed, seek a second opinion.

• #25 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. Depending on the tumor’s size and location, you might need local or general anesthesia during the biopsy. The biopsy might be done with a needle with the help of imaging, or it might be done during surgery. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #26 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved. […] Nerve conduction study. You’re likely to have this test along with your EMG. It measures how quickly your nerves carry electrical signals to your muscles. […] Tumor biopsy. If imaging tests identify a nerve tumor, your healthcare professional might remove and study a small sample of cells from your tumor. This is known as a biopsy. […] Nerve biopsy. To help diagnose the type of tumor, your healthcare professional may take a nerve biopsy. This involves taking a small sample of the tissue and sending it to a lab, where it’s studied to look for signs of cancer.

• #27 When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve in: Journal of Neurosurgery Volume 140 Issue 2 (2023) Journals

  https://thejns.org/view/journals/j-neurosurg/140/2/article-p480.xml

  Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs. […] Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis. […] The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.

• #28 When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve in: Journal of Neurosurgery Volume 140 Issue 2 (2023) Journals

  https://thejns.org/view/journals/j-neurosurg/140/2/article-p480.xml

  Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs. […] Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis. […] The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.

• #29 When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve in: Journal of Neurosurgery Volume 140 Issue 2 (2023) Journals

  https://thejns.org/view/journals/j-neurosurg/140/2/article-p480.xml

  Biopsies of peripheral nerve tumors (PNTs) are often used to plan an efficient treatment strategy. However, performing a biopsy is controversial when the mass is likely to be a benign PNT (BPNT). The aim of this study was to evaluate the side effects of biopsies in patients with potential PNTs. […] Biopsies of PNTs are controversial and may result in misdiagnosis, neuropathic pain, or neurological deficit due to axonal damage, and they may also hinder microsurgical resection when if performed when not indicated. Indications for biopsy of an MUOPON must be carefully considered, especially if BPNT is a possible diagnosis. […] The initial diagnosis obtained by biopsy differed from the final histopathological diagnosis in all patients, of whom 21 (87.5%) had BPNTs, 2 (8.3%) malignant peripheral nerve sheath tumors, and 1 (4.2%) an ancient schwannoma.

• #30

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing. […] However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients.

• #31 Benign peripheral nerve sheath tumors: an interdisciplinary diagnostic and therapeutic challenge

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10439084/

  However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients. […] Misdiagnosis and mistreatment showed a significant correlation with the treating specialist. […] Furthermore, patients receiving MRI of the cervical spine or the lumbar spine as an initial diagnostic tool showed significantly higher rates of misdiagnosis and mistreatment in comparison to patients receiving MRI of another area, which was usually the tumor-bearing region.

• #32 Benign peripheral nerve sheath tumors: an interdisciplinary diagnostic and therapeutic challenge

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10439084/

  However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients. […] Misdiagnosis and mistreatment showed a significant correlation with the treating specialist. […] Furthermore, patients receiving MRI of the cervical spine or the lumbar spine as an initial diagnostic tool showed significantly higher rates of misdiagnosis and mistreatment in comparison to patients receiving MRI of another area, which was usually the tumor-bearing region.

• #33

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  A benign peripheral nerve sheath tumor (bPNST) is a rare lesion associated with peripheral nerval structures. Symptoms may be heterogeneous, complicating diagnosis finding. […] Therefore, we analyzed patients treated for bPNST in our specialized institution with a primary focus on prior misdiagnosis and possible mistreatment. […] Assessment of demographics, tumor entity, tumor location, symptoms, the interval between the onset of symptoms and surgery, involved medical specialties, and outpatients treatment, with particular focus on initial misdiagnosis and inappropriate medical treatment, was performed. […] An incorrect primary diagnosis was detected in 44.7% (n=38), leading to suboptimal or insufficient treatment in these cases. […] For the first time, our data shows the quantity and impact of incorrect initial diagnosis in bPNST causing a delay in causative treatment or resulting in unnecessary or potentially harmful treatment.

• #34

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing. […] However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients.

• #35

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing. […] However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients.

• #36 Benign peripheral nerve sheath tumors: an interdisciplinary diagnostic and therapeutic challenge

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10439084/

  A benign peripheral nerve sheath tumor (bPNST) is a rare lesion associated with peripheral nerval structures. Symptoms may be heterogeneous, complicating diagnosis finding. […] Therefore, we analyzed patients treated for bPNST in our specialized institution with a primary focus on prior misdiagnosis and possible mistreatment. […] An incorrect primary diagnosis was detected in 44.7% (n=38), leading to suboptimal or insufficient treatment in these cases. […] For the first time, our data shows the quantity and impact of incorrect initial diagnosis in bPNST causing a delay in causative treatment or resulting in unnecessary or potentially harmful treatment. […] Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing.

• #37

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Prolonged conservative treatment was present in 28.9%, resulting in pronounced neurological handicaps in two cases and neuropathic pain syndrome in five patients. […] Furthermore, an unnecessary surgical treatment unrelated to the bPNST was performed in 26.3%. […] This led to severe motor and sensory deficits in seven patients and resulted in revision surgery in every case. […] Misdiagnosis and mistreatment showed a significant correlation with the treating specialist. […] Furthermore, patients receiving MRI of the cervical spine or the lumbar spine as an initial diagnostic tool showed significantly higher rates of misdiagnosis and mistreatment in comparison to patients receiving MRI of another area, which was usually the tumor-bearing region. […] Our study presents data on rates of initial misdiagnosis and mistreatment in patients with bPNST. In our series, 44.7% of patients with sporadic bPNST presenting to our specialized institution had an initial misdiagnosis that led to inappropriate surgical treatment in most of these patients (71.1%).

• #38 :: iMRI :: Investigative Magnetic Resonance Imaging

  https://i-mri.org/DOIx.php?id=10.13104/imri.2015.19.3.153

  To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. […] Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. […] In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis. […] MRI plays an essential role in detecting soft tissue tumors, thus enabling treatment plans to be made earlier. However, it is very difficult to make a proper diagnosis based on MRI findings only, and additional pre-operative biopsy is required in many cases.

• #39 :: iMRI :: Investigative Magnetic Resonance Imaging

  https://i-mri.org/DOIx.php?id=10.13104/imri.2015.19.3.153

  To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. […] Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. […] In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis. […] MRI plays an essential role in detecting soft tissue tumors, thus enabling treatment plans to be made earlier. However, it is very difficult to make a proper diagnosis based on MRI findings only, and additional pre-operative biopsy is required in many cases.

• #40 :: iMRI :: Investigative Magnetic Resonance Imaging

  https://i-mri.org/DOIx.php?id=10.13104/imri.2015.19.3.153

  To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. […] Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. […] In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis. […] MRI plays an essential role in detecting soft tissue tumors, thus enabling treatment plans to be made earlier. However, it is very difficult to make a proper diagnosis based on MRI findings only, and additional pre-operative biopsy is required in many cases.

• #41 :: iMRI :: Investigative Magnetic Resonance Imaging

  https://i-mri.org/DOIx.php?id=10.13104/imri.2015.19.3.153

  Although many radiological findings of myxoid tumors and BPNSTs have been reported in previous studies, several imaging findings such as high signal intensity (SI) on T2-weighted image (T2WI), internal septations, and pronounced enhancement, have been found to appear in a similar manner, which makes it difficult to distinguish between myxoid tumors and BPNSTs. […] Thus, making an accurate diagnosis based on MRI findings becomes more difficult, especially when the mass is adjacent to the neurovascular bundle.

• #42 :: iMRI :: Investigative Magnetic Resonance Imaging

  https://i-mri.org/DOIx.php?id=10.13104/imri.2015.19.3.153

  To identify the differential MRI findings between myxoid tumors and benign peripheral nerve sheath tumors (BPNSTs) in the musculoskeletal system. […] Large size, high SI on T2WI, heterogeneous enhancement, and internal fat component were commonly observed in myxoid tumors, while homogenous enhancement, fat split sign, target sign were common in BPNSTs. […] In the differential diagnosis of myxoid tumors and BPNSTs involving the musculoskeletal system, several MRI findings such as degree of SI on T2WI, enhancement homogeneity, internal fat component, fat split sign, and target sign, may be helpful in establishing the diagnosis. […] MRI plays an essential role in detecting soft tissue tumors, thus enabling treatment plans to be made earlier. However, it is very difficult to make a proper diagnosis based on MRI findings only, and additional pre-operative biopsy is required in many cases.

• #43 Peripheral nerve tumors of the hand: Clinical features, diagnosis, and treatment

  https://www.wjgnet.com/2307-8960/full/v8/i21/5086.htm

  Definitive diagnosis for both benign and malignant PNTs is established using microscopic examination, such as histopathological and immunohistochemical analyses. […] Management of benign PNTs is based on the signs and symptoms. […] The goal of treatment is complete surgical removal with maximum reservation of residual neurologic function. […] For MPNSTs, simple surgical resection with a sufficiently wide margin combining RT plays an integral role in the current management, contributing to overall increased survival rates.

• #44 Peripheral nerve tumors of the hand: Clinical features, diagnosis, and treatment

  https://www.wjgnet.com/2307-8960/full/v8/i21/5086.htm

  Definitive diagnosis for both benign and malignant PNTs is established using microscopic examination, such as histopathological and immunohistochemical analyses. […] Management of benign PNTs is based on the signs and symptoms. […] The goal of treatment is complete surgical removal with maximum reservation of residual neurologic function. […] For MPNSTs, simple surgical resection with a sufficiently wide margin combining RT plays an integral role in the current management, contributing to overall increased survival rates.

• #45 Diagnosis and Treatment of Peripheral and Cranial Nerve Tumors with Expert Recommendations: An EUropean Network for RAre CANcers (EURACAN) Initiative

  https://www.mdpi.com/2072-6694/15/7/1930

  Clinical trials on other MEK1-2 inhibitors alone or in combination with mTOR inhibitors are under investigation in plexiform neurofibromas and MPNST, respectively. […] Tumor diagnosis for most of cranial and paraspinal nerve sheath tumors is still primarily based on hematoxylin and eosin (H&E)-stained sections and some additional techniques, including immunohistochemistry. […] However, mutation analysis of PNST may be required to diagnose mosaic forms of NF1, NF2, and SPS through the identification of the same mutation in at least two independent tumors as this is often the only way to prove a mosaicism. […] The presence of infiltrative margins, peritumoral edema and/or necrosis, intra- or peritumoral hemorrhage, an irregular or round shape, a size greater than 5 cm, and a heterogeneous enhancement all suggest a malignant tumor.

• #46 Diagnosis and Treatment of Peripheral and Cranial Nerve Tumors with Expert Recommendations: An EUropean Network for RAre CANcers (EURACAN) Initiative

  https://www.mdpi.com/2072-6694/15/7/1930

  Clinical trials on other MEK1-2 inhibitors alone or in combination with mTOR inhibitors are under investigation in plexiform neurofibromas and MPNST, respectively. […] Tumor diagnosis for most of cranial and paraspinal nerve sheath tumors is still primarily based on hematoxylin and eosin (H&E)-stained sections and some additional techniques, including immunohistochemistry. […] However, mutation analysis of PNST may be required to diagnose mosaic forms of NF1, NF2, and SPS through the identification of the same mutation in at least two independent tumors as this is often the only way to prove a mosaicism. […] The presence of infiltrative margins, peritumoral edema and/or necrosis, intra- or peritumoral hemorrhage, an irregular or round shape, a size greater than 5 cm, and a heterogeneous enhancement all suggest a malignant tumor.

• #47 Morphologic and immunohistochemical features of malignant peripheral nerve sheath tumors and cellular schwannomas | Modern Pathology

  https://www.nature.com/articles/modpathol2014109

  Cellular schwannoma is an uncommon, but well-recognized, benign peripheral nerve sheath tumor, which can be misdiagnosed as malignant peripheral nerve sheath tumor. […] Given dramatically different prognostic and therapeutic implications, distinguishing cellular schwannoma from malignant peripheral nerve sheath tumor is critical. […] The presence of foamy macrophages, a well-formed capsule containing lymphoid aggregates, diffuse strong S100 protein staining and pericellular collagen IV expression support a diagnosis of cellular schwannoma. […] Overall, cellular schwannoma patients had significantly better progression-free and disease-specific survival times than malignant peripheral nerve sheath tumor patients. […] In summary, the presence of Schwannian whorls, a peritumoral capsule, subcapsular lymphocytes, macrophage-rich infiltrates, and the absence of fascicles favor the diagnosis of cellular schwannoma, while the presence of perivascular hypercellularity, tumor herniation into vascular lumens, and necrosis favor malignant peripheral nerve sheath tumor. Complete loss of SOX10, neurofibromin or p16 expression, or the presence of EGFR immunoreactivity strongly favor malignant peripheral nerve sheath tumor. Taken together, immunohistochemistry is useful in the differential diagnosis of malignant peripheral nerve sheath tumor and cellular schwannoma.

• #48 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  Benign peripheral nerve tumors are tumors that form on peripheral nerves. The peripheral nerves link the brain and spinal cord to other parts of the body. These nerves control muscles that allow you to walk, blink, swallow, pick things up and do other activities. Benign tumors are not cancerous. […] It’s important to see your healthcare professional if you have a lump or if you have pain, tingling, numbness or muscle weakness. […] To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve.

• #49 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  To diagnose a peripheral nerve tumor, your health care provider will ask about your symptoms and medical history. You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms. […] Magnetic resonance imaging (MRI). This scan uses a magnet and radio waves to produce a detailed 3D view of nerves and tissue. […] Computerized tomography (CT). A CT scanner rotates around the body to take a series of images. A computer uses the image to make a detailed view of the peripheral nerve tumor. A CT scan can help your provider determine how the tumor may be affecting you. […] Electromyogram (EMG). For this test, small needles are placed in the muscles. An instrument records the electrical activity in the muscle as they’re moved. […] Nerve conduction study. This test is often done with an EMG. It measures how fast the nerves carry electrical signals to the muscles.

• #50 Peripheral nerve sheath tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peripheral-nerve-sheath-tumour-2?lang=us

  Peripheral nerve sheath tumors (PNSTs) are a group of primary neurogenic tumors that arise from nerve sheaths outside of the central nervous system. The vast majority are benign, however, malignant transformation is seen particularly in large tumors and those associated with neurofibromatosis type 1 (NF1). […] Symptoms of benign peripheral nerve sheath tumors are non-specific and include sensory and/or motor deficits, isolated pain, painful mass (i.e. positive Tinel sign), asymptomatic mass or may be incidental. […] Ultrasound or MRI, the latter considered gold-standard, may suggest a neurogenic origin of a soft tissue mass and whether there are benign or malignant features, however, in most cases, imaging cannot reliably distinguish between the different histological subtypes. […] Usually, a presumptive diagnosis is made taking into account patient demographics, pre-existing conditions (e.g. neurofibromatosis type 1 or type 2), the location and size of the tumor, and evidence of rapid growth.

• #51 Peripheral nerve tumors – UpToDate

  https://www.uptodate.com/contents/peripheral-nerve-tumors/print

  Peripheral nerve tumors are a heterogeneous group of mostly benign tumors that are rare in the general population. Certain types, including neurofibromas and schwannomas, may occur sporadically or in association with neurofibromatosis (NF). […] Symptoms and signs of peripheral nerve tumors are caused by direct nerve invasion, involvement of surrounding tissues, or mass effect. There are no specific clinical presentations unique or even especially suggestive of a particular nerve tumor, with the exception of neurofibromatosis type 1 (NF1), NF2-related schwannomatosis (NF2) and schwannomatosis. […] Patients present for evaluation of peripheral nerve tumors because of a soft tissue mass, pain, or focal neurologic findings, approximately in that order of frequency. The duration and progression of symptoms or signs are important, as most benign tumors have a longer duration and a slow rate of progression, while malignant tumors tend to progress rapidly in size, amount of pain, and neurologic deficit.

• #52 Peripheral nerve sheath tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peripheral-nerve-sheath-tumour-2?lang=us

  Peripheral nerve sheath tumors (PNSTs) are a group of primary neurogenic tumors that arise from nerve sheaths outside of the central nervous system. The vast majority are benign, however, malignant transformation is seen particularly in large tumors and those associated with neurofibromatosis type 1 (NF1). […] Symptoms of benign peripheral nerve sheath tumors are non-specific and include sensory and/or motor deficits, isolated pain, painful mass (i.e. positive Tinel sign), asymptomatic mass or may be incidental. […] Ultrasound or MRI, the latter considered gold-standard, may suggest a neurogenic origin of a soft tissue mass and whether there are benign or malignant features, however, in most cases, imaging cannot reliably distinguish between the different histological subtypes. […] Usually, a presumptive diagnosis is made taking into account patient demographics, pre-existing conditions (e.g. neurofibromatosis type 1 or type 2), the location and size of the tumor, and evidence of rapid growth.

• #53 Peripheral nerve sheath tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peripheral-nerve-sheath-tumour-2?lang=us

  Peripheral nerve sheath tumors (PNSTs) are a group of primary neurogenic tumors that arise from nerve sheaths outside of the central nervous system. The vast majority are benign, however, malignant transformation is seen particularly in large tumors and those associated with neurofibromatosis type 1 (NF1). […] Symptoms of benign peripheral nerve sheath tumors are non-specific and include sensory and/or motor deficits, isolated pain, painful mass (i.e. positive Tinel sign), asymptomatic mass or may be incidental. […] Ultrasound or MRI, the latter considered gold-standard, may suggest a neurogenic origin of a soft tissue mass and whether there are benign or malignant features, however, in most cases, imaging cannot reliably distinguish between the different histological subtypes. […] Usually, a presumptive diagnosis is made taking into account patient demographics, pre-existing conditions (e.g. neurofibromatosis type 1 or type 2), the location and size of the tumor, and evidence of rapid growth.

• #54 Peripheral nerve sheath tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peripheral-nerve-sheath-tumour-2?lang=us

  Peripheral nerve sheath tumors (PNSTs) are a group of primary neurogenic tumors that arise from nerve sheaths outside of the central nervous system. The vast majority are benign, however, malignant transformation is seen particularly in large tumors and those associated with neurofibromatosis type 1 (NF1). […] Symptoms of benign peripheral nerve sheath tumors are non-specific and include sensory and/or motor deficits, isolated pain, painful mass (i.e. positive Tinel sign), asymptomatic mass or may be incidental. […] Ultrasound or MRI, the latter considered gold-standard, may suggest a neurogenic origin of a soft tissue mass and whether there are benign or malignant features, however, in most cases, imaging cannot reliably distinguish between the different histological subtypes. […] Usually, a presumptive diagnosis is made taking into account patient demographics, pre-existing conditions (e.g. neurofibromatosis type 1 or type 2), the location and size of the tumor, and evidence of rapid growth.

• #55 Peripheral nerve sheath tumor | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/peripheral-nerve-sheath-tumour-2?lang=us

  Peripheral nerve sheath tumors (PNSTs) are a group of primary neurogenic tumors that arise from nerve sheaths outside of the central nervous system. The vast majority are benign, however, malignant transformation is seen particularly in large tumors and those associated with neurofibromatosis type 1 (NF1). […] Symptoms of benign peripheral nerve sheath tumors are non-specific and include sensory and/or motor deficits, isolated pain, painful mass (i.e. positive Tinel sign), asymptomatic mass or may be incidental. […] Ultrasound or MRI, the latter considered gold-standard, may suggest a neurogenic origin of a soft tissue mass and whether there are benign or malignant features, however, in most cases, imaging cannot reliably distinguish between the different histological subtypes. […] Usually, a presumptive diagnosis is made taking into account patient demographics, pre-existing conditions (e.g. neurofibromatosis type 1 or type 2), the location and size of the tumor, and evidence of rapid growth.

• #56 Peripheral nerve tumors – UpToDate

  https://www.uptodate.com/contents/peripheral-nerve-tumors/print

  Peripheral nerve tumors are a heterogeneous group of mostly benign tumors that are rare in the general population. Certain types, including neurofibromas and schwannomas, may occur sporadically or in association with neurofibromatosis (NF). […] Symptoms and signs of peripheral nerve tumors are caused by direct nerve invasion, involvement of surrounding tissues, or mass effect. There are no specific clinical presentations unique or even especially suggestive of a particular nerve tumor, with the exception of neurofibromatosis type 1 (NF1), NF2-related schwannomatosis (NF2) and schwannomatosis. […] Patients present for evaluation of peripheral nerve tumors because of a soft tissue mass, pain, or focal neurologic findings, approximately in that order of frequency. The duration and progression of symptoms or signs are important, as most benign tumors have a longer duration and a slow rate of progression, while malignant tumors tend to progress rapidly in size, amount of pain, and neurologic deficit.

• #57 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #58 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #59 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #60 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #61 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #62 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #63 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #64 Peripheral nerve tumors // Middlesex Health

  https://middlesexhealth.org/learning-center/diseases-and-conditions/peripheral-nerve-tumors

  Tumor biopsy. If you have a nerve tumor, you may need a biopsy. A small sample of cells from the tumor is removed and analyzed. Depending on the tumor’s size and location, you may need to have medicine that numbs an area of the body, called local anesthesia, or medicine that puts you to sleep, called general anesthesia, during the biopsy. Sometimes a biopsy is the only way to determine whether a tumor is cancerous. […] Nerve biopsy. A biopsy of the nerve may be needed in people who have certain conditions, such as progressive peripheral neuropathy and enlarged nerves that mimic nerve tumors. […] Peripheral nerve tumors aren’t common. It’s important to find a provider who is experienced in diagnosing and treating them. If needed, seek a second opinion.

• #65 Nerve Tumors | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/nerve-tumors

  The OHSU Nerve Center offers the expertise to precisely diagnose and treat peripheral nerve tumors. Specialty care and early diagnosis can be especially important for nerve tumors, which can range from simple to complex. […] Experts who can quickly determine whether your tumor is benign (not cancer) or malignant (cancer). […] Early diagnosis is important for nerve tumors. Malignant peripheral nerve tumors are rare but require aggressive treatment for the best possible outcome. […] At the Nerve Center, we offer the latest tests and the expertise to pinpoint your type of tumor. Tests vary depending on tumor type and location. They may include: A physical exam and discussion of your medical history. Imaging tests, usually with an MRI, CT scan or PET scan. Our sophisticated scanners can detect even small tumors. A biopsy to take a small sample of the tumor for analysis.

• #66 Nerve Tumors | Brain Institute | OHSU

  https://www.ohsu.edu/brain-institute/nerve-tumors

  The OHSU Nerve Center offers the expertise to precisely diagnose and treat peripheral nerve tumors. Specialty care and early diagnosis can be especially important for nerve tumors, which can range from simple to complex. […] Experts who can quickly determine whether your tumor is benign (not cancer) or malignant (cancer). […] Early diagnosis is important for nerve tumors. Malignant peripheral nerve tumors are rare but require aggressive treatment for the best possible outcome. […] At the Nerve Center, we offer the latest tests and the expertise to pinpoint your type of tumor. Tests vary depending on tumor type and location. They may include: A physical exam and discussion of your medical history. Imaging tests, usually with an MRI, CT scan or PET scan. Our sophisticated scanners can detect even small tumors. A biopsy to take a small sample of the tumor for analysis.

• #67 Peripheral Nerve Sheath Tumors in Dogs | PetCure Oncology

  https://petcureoncology.com/peripheral-nerve-sheath-tumors-in-dogs/

  Peripheral nerve sheath tumors in dogs are typically a single mass. […] Early diagnosis thus is very important for any type of mass, especially canine peripheral nerve sheath tumors. […] To specifically diagnose a canine peripheral nerve sheath tumor, a veterinarian would work to rule out other possibilities, including but not limited to other types of sarcomas, a sebaceous adenocarcinoma, a mast cell tumor or a basal cell tumor. […] Tests and procedures that will help a veterinarian reach a diagnosis include: […] Aspiration or biopsy of the mass. An aspiration involves using a fine needle to take a sample of cells for cytologic evaluation, while a biopsy refers to the removal of a portion of the mass or even the entire mass at times. […] Lymph node sampling. If there is concern that the cancer has spread to the regional lymph node(s), your veterinarian may suggest an aspiration cytology or a biopsy of this organ. […] 3-view X-rays. While most peripheral nerve sheath tumors in dogs do not spread to the lungs, some will. […] CT Scan. On occasion, your veterinarian may suggest a CT scan to assess the extent of the tumor as well as evaluate the surgical feasibility.

• #68 Nerve Sheath Tumors: Types, Symptoms, Treatment, Outlook

  https://www.healthline.com/health/nerve-sheath-tumor

  If the scans reveal a tumor, your doctor may perform a biopsy. During a biopsy, a doctor uses a needle to take a small sample from the tumor. They then send the sample to a lab for testing. […] Treatment for nerve sheath tumors depends on where the tumor is in your body and how quickly its growing. […] For malignant tumors, your doctor may use chemotherapy combined with radiation to treat the tumor and keep it from coming back. […] Its important not to delay diagnosis and treatment.

• #69

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Prolonged conservative treatment was present in 28.9%, resulting in pronounced neurological handicaps in two cases and neuropathic pain syndrome in five patients. […] Furthermore, an unnecessary surgical treatment unrelated to the bPNST was performed in 26.3%. […] This led to severe motor and sensory deficits in seven patients and resulted in revision surgery in every case. […] Misdiagnosis and mistreatment showed a significant correlation with the treating specialist. […] Furthermore, patients receiving MRI of the cervical spine or the lumbar spine as an initial diagnostic tool showed significantly higher rates of misdiagnosis and mistreatment in comparison to patients receiving MRI of another area, which was usually the tumor-bearing region. […] Our study presents data on rates of initial misdiagnosis and mistreatment in patients with bPNST. In our series, 44.7% of patients with sporadic bPNST presenting to our specialized institution had an initial misdiagnosis that led to inappropriate surgical treatment in most of these patients (71.1%).

• #70 Magnetic resonance neurography appearance and diagnostic evaluation of peripheral nerve sheath tumors | Scientific Reports

  https://www.nature.com/articles/s41598-019-43450-w

  Imaging appearances of peripheral nerve sheath tumors by MRI are difficult distinguish from soft-tissue tumors. […] The objective of this study was to evaluate the feasibility and imaging appearance of high-resolution 3-T magnetic resonance neurography (MRN) of the diagnosis of peripheral nerve sheath tumors (PNSTs) using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences. […] The imaging findings and characteristic signs of conventional MRI scanning and contrast-enhanced 3D-STIR SPACE sequences were compared. […] Compared to conventional MRI images, imaging appearances including neurogenic origin, length of the peripheral nerves and relation to the nerve of PNSTs on 3D-STIR SPACE images were more accuracy (P0.05). […] 3D STIR SPACE sequences demonstrate its significant capacity to diagnostic evaluate and location of PNSTs.

• #71 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  Doctors may soon be able to use a blood test to distinguish between benign and cancerous tumors in people with NF1. […] Researchers from the National Cancer Institutes (NCI) Center for Cancer Research, part of the National Institutes of Health, and Washington University School of Medicine in St. Louis have developed a blood test that, they believe, could one day offer a highly sensitive and inexpensive approach to detect cancer early in people with NF1. […] Doctors currently use either imaging scans (MRI or PET scan) or biopsies to determine if plexiform neurofibromas have transformed into MPNST. […] What we don’t have right now is a tool to help us determine if within that big, bulky benign plexiform neurofibroma, something bad is cooking and it’s turning into an MPNST, Dr. Shern said.

• #72 Magnetic resonance neurography appearance and diagnostic evaluation of peripheral nerve sheath tumors | Scientific Reports

  https://www.nature.com/articles/s41598-019-43450-w

  Imaging appearances of peripheral nerve sheath tumors by MRI are difficult distinguish from soft-tissue tumors. […] The objective of this study was to evaluate the feasibility and imaging appearance of high-resolution 3-T magnetic resonance neurography (MRN) of the diagnosis of peripheral nerve sheath tumors (PNSTs) using sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) sequences. […] The imaging findings and characteristic signs of conventional MRI scanning and contrast-enhanced 3D-STIR SPACE sequences were compared. […] Compared to conventional MRI images, imaging appearances including neurogenic origin, length of the peripheral nerves and relation to the nerve of PNSTs on 3D-STIR SPACE images were more accuracy (P0.05). […] 3D STIR SPACE sequences demonstrate its significant capacity to diagnostic evaluate and location of PNSTs.

• #73 Magnetic resonance neurography appearance and diagnostic evaluation of peripheral nerve sheath tumors | Scientific Reports

  https://www.nature.com/articles/s41598-019-43450-w

  This article comprehensively reviews radiologic findings and illustrates the MRN features of PNSTs. […] High-resolution 3-T MR neurography (MRN) is an effective technique for examining peripheral nerves. […] MRN can clearly show pathological and normal tissue characteristics and is the technology modality used to evaluate PNSTs because it has obvious advantages in diagnosing PNSTs and evaluating their relationship with the surrounding tissue structure. […] In our research, we reviewed and analyzed MRI conventional scanning imaging and neuroimaging of thirty cases of PNSTs confirmed by postoperative pathology or puncture biopsy. […] We found that contrast-enhanced scans significantly improved the background suppression effect and increased the contrast-noise ratio, thus displaying the length, continuity and morphology of the spinal nerve more prominently. […] 3D-STIR SPACE sequences and contrast-enhanced sequences can show the relationship between tumors and the spinal nerves. […] This technique will be of great clinical value for aiding early diagnoses and will provide guidance for the surgical treatment of PNSTs.

• #74 Magnetic resonance neurography appearance and diagnostic evaluation of peripheral nerve sheath tumors | Scientific Reports

  https://www.nature.com/articles/s41598-019-43450-w

  This article comprehensively reviews radiologic findings and illustrates the MRN features of PNSTs. […] High-resolution 3-T MR neurography (MRN) is an effective technique for examining peripheral nerves. […] MRN can clearly show pathological and normal tissue characteristics and is the technology modality used to evaluate PNSTs because it has obvious advantages in diagnosing PNSTs and evaluating their relationship with the surrounding tissue structure. […] In our research, we reviewed and analyzed MRI conventional scanning imaging and neuroimaging of thirty cases of PNSTs confirmed by postoperative pathology or puncture biopsy. […] We found that contrast-enhanced scans significantly improved the background suppression effect and increased the contrast-noise ratio, thus displaying the length, continuity and morphology of the spinal nerve more prominently. […] 3D-STIR SPACE sequences and contrast-enhanced sequences can show the relationship between tumors and the spinal nerves. […] This technique will be of great clinical value for aiding early diagnoses and will provide guidance for the surgical treatment of PNSTs.

• #75 Correlation between imaging and histology in benign solitary retroperitoneal nerve sheath tumors: a pictorial review | Insights into Imaging | Full Text

  https://insightsimaging.springeropen.com/articles/10.1186/s13244-024-01709-5

  Benign nerve sheath tumors presenting as solitary retroperitoneal masses (RBNSTs) pose a complex diagnostic challenge for multidisciplinary teams regarding differential diagnosis, staging, and treatment planning. […] This educational review critically examines the correlation between imaging and histological features in solitary retroperitoneal benign nerve sheath tumors, offering valuable insights for improving the accuracy of differential diagnosis in clinical radiology. […] RBNSTs are challenging to diagnose because they lack specific radiological features. […] Differential diagnosis of RBNSTs from other retroperitoneal neoplasms on imaging is complex. […] Surgical removal of RBNSTs is recommended for an accurate diagnosis. […] The primary objective of the present review is to highlight the correlation between the histological features and the corresponding radiological characteristics of RBNSTs.

• #76 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  Doctors may soon be able to use a blood test to distinguish between benign and cancerous tumors in people with NF1. […] Researchers from the National Cancer Institutes (NCI) Center for Cancer Research, part of the National Institutes of Health, and Washington University School of Medicine in St. Louis have developed a blood test that, they believe, could one day offer a highly sensitive and inexpensive approach to detect cancer early in people with NF1. […] Doctors currently use either imaging scans (MRI or PET scan) or biopsies to determine if plexiform neurofibromas have transformed into MPNST. […] What we don’t have right now is a tool to help us determine if within that big, bulky benign plexiform neurofibroma, something bad is cooking and it’s turning into an MPNST, Dr. Shern said.

• #77 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  Doctors may soon be able to use a blood test to distinguish between benign and cancerous tumors in people with NF1. […] Researchers from the National Cancer Institutes (NCI) Center for Cancer Research, part of the National Institutes of Health, and Washington University School of Medicine in St. Louis have developed a blood test that, they believe, could one day offer a highly sensitive and inexpensive approach to detect cancer early in people with NF1. […] Doctors currently use either imaging scans (MRI or PET scan) or biopsies to determine if plexiform neurofibromas have transformed into MPNST. […] What we don’t have right now is a tool to help us determine if within that big, bulky benign plexiform neurofibroma, something bad is cooking and it’s turning into an MPNST, Dr. Shern said.

• #78 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  Doctors may soon be able to use a blood test to distinguish between benign and cancerous tumors in people with NF1. […] Researchers from the National Cancer Institutes (NCI) Center for Cancer Research, part of the National Institutes of Health, and Washington University School of Medicine in St. Louis have developed a blood test that, they believe, could one day offer a highly sensitive and inexpensive approach to detect cancer early in people with NF1. […] Doctors currently use either imaging scans (MRI or PET scan) or biopsies to determine if plexiform neurofibromas have transformed into MPNST. […] What we don’t have right now is a tool to help us determine if within that big, bulky benign plexiform neurofibroma, something bad is cooking and it’s turning into an MPNST, Dr. Shern said.

• #79 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  The cell-free DNA in patients with MPNST had several features that distinguished it from the DNA in the other two groups. […] Together, these differences allowed the researchers to differentiate, with 86% accuracy, between patients with plexiform neurofibromas and those with MPNST. […] A simple and inexpensive blood test to detect MPNST early in NF1 patients would be especially useful in developing countries and other resource-poor areas, where access to the equipment and expertise needed to perform imaging is limited, Dr. Shern said. […] Blood tests of this type also have applications in the early detection and monitoring of patients with other cancer-predisposing genetic disorders, such as multiple endocrine neoplasia, in which benign tumors can turn cancerous, or Li-Fraumeni syndrome, which increases ones risk for developing several types of cancer.

• #80 Blood test to distinguish benign versus cancerous NF1 tumors – NCI

  https://www.cancer.gov/news-events/press-releases/2021/neurofibromatosis-cancer-blood-test

  The cell-free DNA in patients with MPNST had several features that distinguished it from the DNA in the other two groups. […] Together, these differences allowed the researchers to differentiate, with 86% accuracy, between patients with plexiform neurofibromas and those with MPNST. […] A simple and inexpensive blood test to detect MPNST early in NF1 patients would be especially useful in developing countries and other resource-poor areas, where access to the equipment and expertise needed to perform imaging is limited, Dr. Shern said. […] Blood tests of this type also have applications in the early detection and monitoring of patients with other cancer-predisposing genetic disorders, such as multiple endocrine neoplasia, in which benign tumors can turn cancerous, or Li-Fraumeni syndrome, which increases ones risk for developing several types of cancer.

• #81 PERIPHERAL NERVE TUMORS – Dr Prem Pillay

  https://singaporebrain.org/en/nerves/peripheral-nerve-tumors/

  Peripheral nerve tumors are a heterogeneous group of neoplasms that arise from or affect nerves outside the brain and spinal cord. According to the 2021 WHO classification of the Central Nervous System (CNS), peripheral nerve sheath tumors (PNSTs) comprise a set of unique entities each with specific clinical, anatomical, histological, and molecular features. Broadly, PNSTs can be subdivided into benign and malignant forms, often reflecting differences in their behavior, prognosis, and recommended treatments. […] Imaging studies are central in delineating the location and extent of the tumor. […] Considered the gold standard for visualizing peripheral nerve tumors, MRI provides high-resolution images that can define the relationship between the tumor and adjacent structures. Certain MRI sequences (such as diffusion-weighted imaging) are investigated for differentiating benign from malignant lesions.

• #82 PERIPHERAL NERVE TUMORS – Dr Prem Pillay

  https://singaporebrain.org/en/nerves/peripheral-nerve-tumors/

  A core or excisional biopsy is typically performed to confirm histopathology, determine tumor grade, and guide treatment decisions. […] Accurate diagnosis via imaging and biopsy, alongside precision surgical techniques, can often lead to remission in benign lesions and offer the best chance for disease control in malignant ones.

• #83

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup of a bPNST includes MRI, neurosonography, and electrophysiology. MRI is obligatory to confirm or exclude the suspected diagnosis. […] The misinterpretation of a symptom and/or the radiological imaging may lead to unnecessary or inappropriate surgical treatment unrelated to the actual disease or to a more radical surgical treatment. […] Treatment should be performed only at a specialized center.

• #84

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup of a bPNST includes MRI, neurosonography, and electrophysiology. MRI is obligatory to confirm or exclude the suspected diagnosis. […] The misinterpretation of a symptom and/or the radiological imaging may lead to unnecessary or inappropriate surgical treatment unrelated to the actual disease or to a more radical surgical treatment. […] Treatment should be performed only at a specialized center.

• #85 Benign peripheral nerve tumor | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/benign-peripheral-nerve-tumor?content_id=CON-20341913

  Benign peripheral nerve tumors are tumors that form on peripheral nerves. The peripheral nerves link the brain and spinal cord to other parts of the body. These nerves control muscles that allow you to walk, blink, swallow, pick things up and do other activities. Benign tumors are not cancerous. […] It’s important to see your healthcare professional if you have a lump or if you have pain, tingling, numbness or muscle weakness. […] To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve.

• #86 Benign peripheral nerve tumor | UM Health-Sparrow

  https://www.uofmhealthsparrow.org/departments-conditions/conditions/benign-peripheral-nerve-tumor

  To diagnose a peripheral nerve tumor, your healthcare professional runs tests to find where the tumor is located and what type of tumor it is. […] You might need one or more of the following tests. […] MRI. This is the preferred method for imaging peripheral nerve tumors. This scan uses a magnetic field and radio waves to produce a detailed 3D view of the nerves and surrounding tissue. It can help determine whether you have a tumor and whether the tumor is inside or outside the nerve. […] CT scan. A CT scanner rotates around the body to record a series of images. This test is not as useful as an MRI in diagnosing a peripheral nerve tumor. However, your healthcare professional might recommend it if you can’t have an MRI or if they need more details about the bone near the tumor. […] Electromyogram (EMG). This test records the electrical activity in a muscle when you try to move it. It is used to help locate the tumor and identify which nerves are involved.

• #87 Diagnosing Peripheral Nerve Sheath Tumors | Neurological Surgery

  https://neurosurgery.weillcornell.org/condition/peripheral-nerve-sheath-tumors/diagnosing-peripheral-nerve-sheath-tumors

  Diagnosis of a peripheral nerve sheath tumors involves begins with a comprehensive history to learn the evolution of the patients symptoms as well as the familys health history. The doctor will then perform a neurologic and physical exam to check for any signs of numbness, weakness, or abnormal reflexes, and examine the body for swelling or bumps. A thorough dermatologic exam for any skin lesions and a hearing test may be ordered, as well as blood tests and genetic testing, which may uncover certain inherited syndromes. […] There are several imaging tests that the medical team at Weill Cornell Medicine Brain and Spine Center can perform to diagnose a peripheral nerve sheath tumor, pinpoint its location, see what structures it is affecting, and decide on the best treatment options. […] Magnetic resonance imaging (MRI) uses a high-powered magnet without radiation to produce detailed, three-dimensional images of the nerves and surrounding tissue

• #88 Diagnosis and Treatment of Peripheral and Cranial Nerve Tumors with Expert Recommendations: An EUropean Network for RAre CANcers (EURACAN) Initiative

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10093509/

  The 2021 WHO classification of the CNS Tumors identifies as Peripheral nerve sheath tumors (PNST) some entities with specific clinical and anatomical characteristics, histological and molecular markers, imaging findings, and aggressiveness. […] Tumor diagnosis is primarily based on hematoxylin and eosin-stained sections and immunohistochemistry. […] MRI is the gold-standard to delineate the extension with respect to adjacent structures. […] Gross-total resection is the first choice, and can be curative in benign lesions; however, the extent of resection must be balanced with preservation of nerve functioning. […] Radiotherapy can be omitted in benign tumors after complete resection and in NF-related tumors, due to the theoretic risk of secondary malignancies in a tumor-suppressor syndrome. […] Systemic therapy should be considered in incomplete resected plexiform neurofibromas/MPNSTs. […] Clinical trials on other MEK1-2 inhibitors alone or in combination with mTOR inhibitors are under investigation in plexiform neurofibromas and MPNST, respectively.

• #89

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing. […] However, one major symptom may be a local swelling or a palpable lump that may lead some clinicians to make wrong assumptions regarding tumor origin when careful neurologic assessment is not performed. […] A nervous origin might not be assumed initially, leading to treatment according to the respective guidelines. Consequently, the initial diagnosis and treatment may not be performed by someone experienced in treating benign peripheral nerve lesions, which promotes delayed diagnosis and nerve damage. […] We aimed to evaluate the rate of primary misdiagnosis and mistreatment in patients suffering from deep-seated bPNSTs. […] An initial incorrect diagnosis was made in 44.7% of patients.

• #90 When biopsy goes wrong: a case series of misdiagnoses and complications from biopsies of masses of unknown origin potentially originating from a peripheral nerve in: Journal of Neurosurgery Volume 140 Issue 2 (2023) Journals

  https://thejns.org/view/journals/j-neurosurg/140/2/article-p480.xml

  The efficacy and necessity of biopsies prior to surgical excision, as an adjunct to imaging, is not always straightforward. If the mass appears to be a clinically benign PNT (BPNT), biopsy is not always warranted. […] The precise identification of a PNT can be challenging when there is insufficient tissue, a lack of specific morphological criteria, the absence of an experienced neuropathologist, or any combination of these. […] Our study is the first to discuss the misdiagnosis of MUOPON based on biopsies, because all our patients had either an inconclusive or erroneous diagnosis based on their examination. Misdiagnosis may lead to the need for a new biopsy procedure or to nononcological management for lesions that are actually malignant. […] The indications of biopsy are well documented, mostly when a malignancy is suspected, but the removal of tissue for analysis in cases of a probable benign masses is controversial.

• #91 PERIPHERAL NERVE TUMORS – Dr Prem Pillay

  https://singaporebrain.org/en/nerves/peripheral-nerve-tumors/

  A core or excisional biopsy is typically performed to confirm histopathology, determine tumor grade, and guide treatment decisions. […] Accurate diagnosis via imaging and biopsy, alongside precision surgical techniques, can often lead to remission in benign lesions and offer the best chance for disease control in malignant ones.

• #92 Surgical outcome of isolated benign peripheral nerve sheath tumors without neurofibromatosis | Egyptian Journal of Neurosurgery | Full Text

  https://ejns.springeropen.com/articles/10.1186/s41984-024-00297-2

  Benign peripheral nerve sheath tumors (BPNSTs) include schwannomas and neurofibromas. […] Surgical resection remains the treatment of choice of BPNSTs because they may cause neural compromise, rapid growth, and pressure they apply to nearby structures. […] However, to diagnose a symptomatic PNSTs we depend on clinical examination, ultrasound, and MRI scan. […] A precise diagnosis is crucial for the treatment of any tumor. […] MRI proved to be very useful for us. […] Ultrasonography became more refined and can help with better diagnosis. […] Schwannomas grow outside the nerve bundles from which they originate, but neurofibromas are mixed with many nerve bundles and are harder to remove completely, regardless of how easy they are to reach. […] Nerve trunks in the limbs can be clinically diagnosed easily and the optimal treatment is to excise the tumor while maintaining nerve function. […] Benign peripheral nerve sheath tumors are safely resected without increased sensory and motor deficits after surgery and with improved clinical outcome with no recurrence on follow up.

• #93

  https://link.springer.com/article/10.1007/s10143-023-02107-z

  Diagnostic workup of a bPNST includes MRI, neurosonography, and electrophysiology. MRI is obligatory to confirm or exclude the suspected diagnosis. […] The misinterpretation of a symptom and/or the radiological imaging may lead to unnecessary or inappropriate surgical treatment unrelated to the actual disease or to a more radical surgical treatment. […] Treatment should be performed only at a specialized center.

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