Neurilemmoma Treatment & Management

  • Author: Ian D Dickey, MD, FRCSC; Chief Editor: Harris Gellman, MD   more...
 
Updated: Jan 21, 2010
 

Surgical Therapy

As with most benign tumors, neurilemmomas respond well to local resection. On inspection, usually the nerve is splayed out over the lesion. The lesion is excised marginally, and the nerve fibers are spared. Interlesional resection is warranted when complete resection would result in permanent neurologic deficit. Local control is usually excellent.[9, 10, 11, 12, 13, 14]

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Complications

The most common complication is initial neuropraxia; however, this neurologic deficit can be permanent, depending on the resection of neural tissue. Generally, patients tolerate resection well, with complete and rapid relief of symptoms.

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Outcome and Prognosis

Recurrence is unlikely following complete resection. Patients usually have rapid and complete relief of pain, with excellent long-term results.

Rare descriptions exist of malignant change in long-standing neurilemmomas, usually in patients with an underlying diagnosis of neurofibromatosis. Malignant change is extremely rare in isolated lesions.

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Contributor Information and Disclosures
Author

Ian D Dickey, MD, FRCSC  Adjunct Professor, Department of Chemical and Biological Engineering, University of Maine; Consulting Staff, Adult Reconstruction, Orthopedic Oncology, Department of Orthopedics, Eastern Maine Medical Center

Ian D Dickey, MD, FRCSC is a member of the following medical societies: American Academy of Orthopaedic Surgeons, British Columbia Medical Association, Canadian Medical Association, and Royal College of Physicians and Surgeons of Canada

Disclosure: Stryker Orthopaedics Consulting fee Consulting; Cadence Honoraria Speaking and teaching

Coauthor(s)

James Floyd, MD  Consulting Staff, Section of Orthopedic Surgery, Manatee Memorial Hospital

James Floyd, MD is a member of the following medical societies: Florida Medical Association, Florida Orthopaedic Society, and National Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Howard A Chansky, MD  Associate Professor, Department of Orthopedics and Sports Medicine, University of Washington Medical Center

Howard A Chansky, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Sean P Scully, MD, PhD  Professor, Department of Orthopedics, University of Miami

Sean P Scully, MD, PhD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, International Society on Thrombosis and Haemostasis, and Society of Surgical Oncology

Disclosure: Nothing to disclose.

Dinesh Patel, MD, FACS  Associate Clinical Professor of Orthopedic Surgery, Harvard Medical School; Chief of Arthroscopic Surgery, Department of Orthopedic Surgery, Massachusetts General Hospital

Dinesh Patel, MD, FACS is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Harris Gellman, MD  Consulting Surgeon, Broward Hand Center; Voluntary Clinical Professor of Orthopedic Surgery and Plastic Surgery, Departments of Orthopedic Surgery and Surgery, University of Miami, Leonard M Miller School of Medicine

Harris Gellman, MD is a member of the following medical societies: American Academy of Medical Acupuncture, American Academy of Orthopaedic Surgeons, American Orthopaedic Association, American Society for Surgery of the Hand, and Arkansas Medical Society

Disclosure: Nothing to disclose.

References

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The cell of origin for a neurilemmoma is the Schwann cell, which is derived from the neural crest. These cells line the peripheral nerve processes.
Neurilemmomas have very distinctive appearances on magnetic resonance images. Many investigators believe that the presence of a target sign on a peripheral nerve is diagnostic for a neurilemmoma.
Pathology specimen.
 
 
 
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