Treatment strategy for benign nerve tumors

BATISTA, KATIA TORRES; Y-SCHWARTZMAN, ULISES PRIETO; SILVA, ROGERIO SANTOS; MARTINS, VALNEY CLAUDINO SAMPAIO; CORREIA, CAROLINA ZAMPRONHA; SILVA, CAMILA FREIRE PARENTE ALVES DA; CORREIA, ISABEL CRISTINA

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Revista Brasileira de Cirurgia Plástica

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Original Article • Rev. Bras. Cir. Plást. 35 (1) • Jan-Mar 2020 • https://doi.org/10.5935/2177-1235.2020RBCP0011 copy

Treatment strategy for benign nerve tumors

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Peripheral nerve tumors are usually benign, rare, slow-growing and little symptomatic. The objective is to describe strategies for the diagnosis and treatment of patients with benign tumors of the ulnar nerve.

Methods:

This retrospective study of patients who underwent surgery between 2010 and 2015 for the treatment of benign tumor of the ulnar nerve analyzed patient symptoms and demographic characteristics, complementary examinations, and surgical techniques performed.

Results:

The study included 17 (8%) patients, with a prevalence of women (65%) in the fourth decade of life. The tumors tended to be extrinsic, with lipoma in 6 cases (35%); others were intrinsic, including schwannoma in 17% and hamartoma in 11% of the cases. Tumor excision was complete in 83% of cases and partial in 17% of cases; nerve decompression was performed in 12 cases.

Conclusion:

The strategies performed here yielded good functional results in 88% of patients. The worst results were in tumors of vascular origin.

Keywords:
Ulnar nerve; Ulnar nerve compression syndromes; Neoplasms; Surgery, Plastic; Microsurgery

Tumor	Location	N	Surgical Procedures	Results
Lipoma	4 wrist and hand 2 elbow	6	3 - total tumor resection + neural decompression 3 - total extraneural tumor resection	Normal
Schwannoma	1 elbow 2 fist	3	Total intraneural tumor resection + neural decompression	Normal
Lipofibromatous hamartoma	2 wrist and hand	2	Disarticulation of finger + neural decompression and partial tumor resection	1 - improvement in function and electromyographic findings1 - maintenance of electromyographic findings
Hemangioma	Fist	1	Partial resection + neural decompression + partial tumor resection	Persistence compressive symptoms
Synovial cyst	Distal forearm	1	Total tumor resection	Normal
Glomus tumor	Forearm	1	Partial tumor resection	Tumor recurrence, ulnar paresthesia
Giant cell tumor	Fist	1	Tumoral resection + neural decompression	Normal
Neurofibroma	Wrist and hand	1	Intraneural resection + neural decompression + partial tumor resection	Improvement in function and pain
Gouty tophus	Elbow	1	Tumor resection and neural decompression + partial tumor resection	Normal
Total		17

Tumor	N	Positive compressive symptoms	Electroneuromyography positive for ulnar nerve
Lipoma	6	3	Normal
Lipofibromatous hamartoma	2	Negative	1 sensory lesion of the fifth finger 1 normal
Hemangioma	1	Negative	Normal
Synovial cyst	1	Negative	Normal
Glomus tumor	1	1	1 lesion of the ulnar nerve motor fibers, discreet, without denervating activity
Giant cell tumor	1	1	Normal
Neurofibroma	1	1	Normal
Gouty tophus	1	1	1 myelin lesion of the ulnar nerve on the elbow

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[1] *Corresponding author: Katia Torres Batistae SMHS 501, Bloco A, Brasília, DF, Brazil. Zip Code: 70335-901. E-mail: katiatb@terra.com.br