Schwannoma of the upper extremity; a clinical series

Abstract

Schwannoma, the most common primary neural tumor of the upper extremity, arises from schwann cells of nerve sheet. The tumor is usually painless and slow growing. Symptomatic masses could be treated through intra- or extra-capsular excision. We aim to evaluate long-term results of surgical treatment of 12 cases of hand Schwannoma.

Twelve cases of confirmed schwannoma who were treated in Imam Khomeini university hospital, Tehran, Iran during 2011 to 2022 were included. All operations were done using loupe magnification or under microscope. After incising the tumor capsule, nerve fibres were isolated then the mass resected. Age, sex, location of the mass, size of the tumor, affected nerve, histological diagnosis, and clinical follow-up including neurological status of patients were documented.

Twelve patients with a mean age of 44 years were included. Seven (58.3%) were male and five (41.66%) were female. The mean follow-up period was 45 months (range: 6–135). Hand was the most common location of involvement and digital nerve was the most frequent origin of schwannoma. Postoperative evaluation showed no tumor recurrence and pain resolved in all twelve patients (100%). Sensory dysfunction resolved completely in 5 out of 8 patients who reported sensory impairment preoperatively (62.5%) and no motor function improvement was seen in patient with motor deficit.

In conclusion, adequate operative techniques can lead to complete tumor removal without neurological loss or recurrence. Neural function improvement in most cases is achieved. New neurologic impairment after excision of schwannoma is rare.