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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 3, 382-387.
doi: 10.1302/0301-620X.89B3.18123  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Benign solitary schwannomas

A REVIEW OF 234 CASES

D. M. A. Knight, MBBS, MRCS, BSc(Hons), Specialist Registrar in Trauma and Orthopaedics1; R. Birch, MChir FRCS, Orthopaedic Surgeon PNI Unit1; and J. Pringle, MBChB, FRCS, Honorary Consultant Histopathologist1

1 Department of Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK.

Correspondence should be sent to Miss D. M. A. Knight; e-mail: dmaknight{at}rcsed.ac.uk

We reviewed 234 benign solitary schwannomas treated between 1984 and 2004. The mean age of the patients was 45.2 years (11 to 82). There were 170 tumours (73%) in the upper limb, of which 94 (40%) arose from the brachial plexus or other nerves within the posterior triangle of the neck. Six (2.6%) were located within muscle or bone. Four patients (1.7%) presented with tetraparesis due to an intraspinal extension.

There were 198 primary referrals (19 of whom had a needle biopsy in the referring unit) and in these patients the tumour was excised. After having surgery or an open biopsy at another hospital, a further 36 patients were seen because of increased neurological deficit, pain or incomplete excision. In these, a nerve repair was performed in 18 and treatment for pain or paralysis was offered to another 14.

A tender mass was found in 194 (98%) of the primary referrals. A Tinel-like sign was recorded in 155 (81%). Persistent spontaneous pain occurred in 60 (31%) of the 194 with tender mass, impairment of cutaneous sensibility in 39 (20%), and muscle weakness in 24 (12%).

After apparently adequate excision, two tumours recurred. No case of malignant transformation was seen.




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Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General