Malignant peripheral nerve sheath tumour of the oral and maxillofacial region-A systematic review

Oral Dis. 2022 Nov;28(8):2072-2082. doi: 10.1111/odi.13982. Epub 2021 Aug 12.

Abstract

To integrate the available data published on malignant peripheral nerve sheath tumours (MPNST) of the oral and maxillofacial region. Searches in Embase, PubMed, Web of Science and Scopus were conducted for the identification of case reports/case series in English language. The risk of bias was assessed using the Joanna Briggs Institute tool. Outcomes were evaluated by Cox regression and Kaplan-Meier methods. A total of 306 articles were retrieved, 50 of which reporting 57 MPNST were included. The lesion showed a predilection for the mandible (n = 18/31.57%) of middle-aged adults (~40.5 years) with a male/female ratio of 1.1:1. The individuals were mostly symptomatic with a mean evolution time of 9.6 months. Surgical removal plus adjuvant therapy (especially radiotherapy) was the main approach (51.86%). Recurrence was reported in 39.62% of cases. Nodal and distant metastases were identified in 28.26% and 26.66% of cases, respectively. The 2-year cumulative survival rate was 55%. Independent predictors of poor survival were the presence of neurofibromatosis type 1 (p = 0.04) and distant metastases (p = 0.004). The diagnosis of MPNST is challenging due to the variety of its clinical and histopathological presentations. Local aggressiveness and the potential for metastases are common outcomes of this neoplasm.

Keywords: MPNST; malignant peripheral nerve sheath tumour; malignant schwannoma; oral cancer; oral oncology.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms*
  • Neoplasm Recurrence, Local
  • Nerve Sheath Neoplasms* / diagnosis
  • Nerve Sheath Neoplasms* / pathology
  • Nerve Sheath Neoplasms* / surgery
  • Neurofibromatosis 1* / diagnosis
  • Neurofibromatosis 1* / pathology
  • Neurofibromatosis 1* / therapy
  • Neurofibrosarcoma*