Benign Peripheral Non-cranial Nerve Sheath Tumors of the Neck

Adv Ther. 2022 Aug;39(8):3449-3471. doi: 10.1007/s12325-022-02191-5. Epub 2022 Jun 11.

Abstract

Benign peripheral non-cranial nerve sheath tumors are rare lesions, including both schwannomas and neurofibromas. These tumors arise from Schwann cells, and may originate from any peripheral, cranial, or autonomic nerve. Most of them are localized and sporadic but multifocal systemic forms can occur. Cervical sympathetic chain, brachial plexus, cervical plexus and spinal roots and nerves are the major nerve systems commonly affected. Dumbbell-shaped intra- and extradural tumors occur most commonly in the cervical spine, as well as purely extradural and paravertebral tumors. The management of these tumors has improved greatly owing to the developments in imaging techniques and surgical innovations such as endoscopically assisted approaches and robotic surgery. Microsurgical intracapsular excision of the tumor helped by the use of intraoperative fluorescent dyes and intraoperative neurophysiological monitoring minimize postoperative neural deficit, since most schwannomas are encapsulated. Most tumors can be removed with a low rate of complications and recurrence. Radiotherapy should be considered for growing lesions that are not amenable to surgery. In asymptomatic patients, observation and serial scans is an option for elderly infirm patients.

Keywords: Brachial plexus; Neurofibroma; Non-cranial nerves; Schwannoma; Spinal nerves; Sympathetic chain.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Humans
  • Nerve Sheath Neoplasms* / diagnostic imaging
  • Nerve Sheath Neoplasms* / pathology
  • Nerve Sheath Neoplasms* / surgery
  • Neurilemmoma* / diagnostic imaging
  • Neurilemmoma* / pathology
  • Neurilemmoma* / surgery
  • Neurofibroma* / pathology
  • Neurofibroma* / surgery
  • Neurosurgical Procedures