Surgical management of multiple schwannomas scattered on a single peripheral nerve

Abstract Background Schwannoma is a common benign tumor. Most schwannomas are sporadic, but approximately 5% of schwannomas are multifocal. Schwannomas are sometimes present in a skip-like pattern on a single continuous peripheral nerve (Multiple schwannomas scattered on a single peripheral nerve: M...

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Main Authors: Toshio Kojima, Seiichi Matsumoto, Masanori Saito, Yuki Funauchi, Keiko Hayakawa, Taisuke Tanizawa, Keisuke Ae
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-02966-x
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author Toshio Kojima
Seiichi Matsumoto
Masanori Saito
Yuki Funauchi
Keiko Hayakawa
Taisuke Tanizawa
Keisuke Ae
author_facet Toshio Kojima
Seiichi Matsumoto
Masanori Saito
Yuki Funauchi
Keiko Hayakawa
Taisuke Tanizawa
Keisuke Ae
author_sort Toshio Kojima
collection DOAJ
description Abstract Background Schwannoma is a common benign tumor. Most schwannomas are sporadic, but approximately 5% of schwannomas are multifocal. Schwannomas are sometimes present in a skip-like pattern on a single continuous peripheral nerve (Multiple schwannomas scattered on a single peripheral nerve: MSSPN). In this study, we present the clinical characteristics of MSSPN in the limbs and propose a treatment strategy based on treatment outcomes. Methods The medical records of 918 patients diagnosed with schwannoma in the limbs were retrospectively reviewed. Among these cases, multiple schwannomas occurring in a single peripheral nerve and spaced more than 1 cm apart were defined as MSSPN. We investigated the clinical characteristics and surgical outcomes. Results Seven patients with MSSPN in the limbs were identified, which represented 0.8% of all cases. There were six females and one male, and the mean age was 50 years. The location of MSSPN was the upper limbs in two cases and the lower limbs in five cases. After surgery, among the five cases in which all tumors were enucleated, neurological symptoms worsened in 4 cases, all of which involved deep nerve tumors. The one case among these five cases in which neurological symptoms improved involved a superficial subcutaneous tumor. Neurological symptoms improved in both of the two cases in which only the tumor causing the main complaint was enucleated; both cases involved deep nerve tumors. The average postoperative follow-up was 8 months, and no cases required reoperation or complained of recurrence. Conclusion This is the first study to address the surgical strategies of multiple schwannomas occurring in a skip-like pattern on a single peripheral nerve. In surgery for MSSPN, selective enucleation of only the most symptomatic tumors may be effective in preventing the worsening of symptoms after surgery.
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spelling doaj-art-a1c010d9c2e747349b69ddd665d5dccd2025-08-20T02:05:45ZengBMCBMC Surgery1471-24822025-06-012511510.1186/s12893-025-02966-xSurgical management of multiple schwannomas scattered on a single peripheral nerveToshio Kojima0Seiichi Matsumoto1Masanori Saito2Yuki Funauchi3Keiko Hayakawa4Taisuke Tanizawa5Keisuke Ae6The Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchThe Department of Orthopedics Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer ResearchAbstract Background Schwannoma is a common benign tumor. Most schwannomas are sporadic, but approximately 5% of schwannomas are multifocal. Schwannomas are sometimes present in a skip-like pattern on a single continuous peripheral nerve (Multiple schwannomas scattered on a single peripheral nerve: MSSPN). In this study, we present the clinical characteristics of MSSPN in the limbs and propose a treatment strategy based on treatment outcomes. Methods The medical records of 918 patients diagnosed with schwannoma in the limbs were retrospectively reviewed. Among these cases, multiple schwannomas occurring in a single peripheral nerve and spaced more than 1 cm apart were defined as MSSPN. We investigated the clinical characteristics and surgical outcomes. Results Seven patients with MSSPN in the limbs were identified, which represented 0.8% of all cases. There were six females and one male, and the mean age was 50 years. The location of MSSPN was the upper limbs in two cases and the lower limbs in five cases. After surgery, among the five cases in which all tumors were enucleated, neurological symptoms worsened in 4 cases, all of which involved deep nerve tumors. The one case among these five cases in which neurological symptoms improved involved a superficial subcutaneous tumor. Neurological symptoms improved in both of the two cases in which only the tumor causing the main complaint was enucleated; both cases involved deep nerve tumors. The average postoperative follow-up was 8 months, and no cases required reoperation or complained of recurrence. Conclusion This is the first study to address the surgical strategies of multiple schwannomas occurring in a skip-like pattern on a single peripheral nerve. In surgery for MSSPN, selective enucleation of only the most symptomatic tumors may be effective in preventing the worsening of symptoms after surgery.https://doi.org/10.1186/s12893-025-02966-xMultiple schwannomasSegmental schwannomatosisMultiple schwannomas scattered on a single peripheral nerveTreatment strategySelective enucleation
spellingShingle Toshio Kojima
Seiichi Matsumoto
Masanori Saito
Yuki Funauchi
Keiko Hayakawa
Taisuke Tanizawa
Keisuke Ae
Surgical management of multiple schwannomas scattered on a single peripheral nerve
BMC Surgery
Multiple schwannomas
Segmental schwannomatosis
Multiple schwannomas scattered on a single peripheral nerve
Treatment strategy
Selective enucleation
title Surgical management of multiple schwannomas scattered on a single peripheral nerve
title_full Surgical management of multiple schwannomas scattered on a single peripheral nerve
title_fullStr Surgical management of multiple schwannomas scattered on a single peripheral nerve
title_full_unstemmed Surgical management of multiple schwannomas scattered on a single peripheral nerve
title_short Surgical management of multiple schwannomas scattered on a single peripheral nerve
title_sort surgical management of multiple schwannomas scattered on a single peripheral nerve
topic Multiple schwannomas
Segmental schwannomatosis
Multiple schwannomas scattered on a single peripheral nerve
Treatment strategy
Selective enucleation
url https://doi.org/10.1186/s12893-025-02966-x
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