Benign solitary schwannomas (neurilemomas)

Abstract

Three hundred and three patients with benign solitary neurilemomas, or schwannomas, not associated with the classical type of von Recklinghausen's disease were studied. One hundred and seventy-two were women and 131 were men. Forty-five percent of the tumors were seen in the extremities, and no specific area could be related to the development of these tumors. Approximately 9% of the tumors occurred in the soft tissues of the trunk and 14% in various unusual sites. Most patients were seen initially because of a painless mass; only 10 complained of pain radiating along the course of a peripheral nerve. One documented case of a malignant degeneration in a benign schwannoma has been reported. The treatment of a benign solitary neurilemoma is enucleation. Excision of a segment of a major peripheral nerve is contraindicated. The histologic features of benign peripheral nerve tumors were briefly described. The confusion regarding terminology has been discussed, and it is suggested that the term schwannoma be more frequently used. The lack of neurologic deficit in schwannomas arising in major peripheral nerves has been pointed out, and further studies have been suggested. The high association of malignant tumors in these patients has been discussed, and it is proposed that a further study be undertaken to ascertain whether these patients are more prone to develop unrelated cancers.