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Semin Musculoskelet Radiol 2022; 26(02): 172-181
DOI: 10.1055/s-0042-1742704
Review Article

Magnetic Resonance Imaging of Nerve Tumors

Barzin Behzad
1   Department of Radiology, Division of Musculoskeletal Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
,
Saeed Dianat 
1   Department of Radiology, Division of Musculoskeletal Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Abstract

Nerve tumors are uncommon soft tissue neoplasms predominantly arising from peripheral nerve sheath and Schwann cells. We review the manifestations of benign peripheral nerve sheath tumors, concentrating on distinguishing imaging features of schwannomas versus neurofibromas with an emphasis on treatment implications. Nevertheless, there is often an overlap between the imaging presentation of these two conditions, making the accurate radiologic diagnosis challenging. Therefore, tissue sampling is often needed for a definitive histologic diagnosis. Treatment planning largely depends on symptoms, location of the lesion, and underlying risk factors. Three major syndromes, neurofibromatosis type 1, type 2, and schwannomatosis, predispose patients to peripheral nerve sheath tumors (PNSTs), with particular concern about the malignant subtype expression. In patients with suspected PNSTs, correlation of imaging findings with clinical findings and genetic tests is helpful for a more accurate diagnosis and disease management. Some imaging features on magnetic resonance imaging and fluorodeoxyglucose-positron emission tomography can be helpful to differentiate malignant from benign subtypes.

Keywords

peripheral nerve sheath tumor - benign - malignant - neurofibromatosis - magnetic resonance imaging

Supplementary Material



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Artikel online veröffentlicht:
24. Mai 2022

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  • References

  • 1 Tagliafico AS, Isaac A, Bignotti B, Rossi F, Zaottini F, Martinoli C. Nerve tumors: what the MSK radiologist should know. Semin Musculoskelet Radiol 2019; 23 (01) 76-84
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 2 Gilchrist JM, Donahue JE. Peripheral nerve tumors. In: Shefner JM, Maki R, Tung GA. eds. UpToDate; 2021. Accessed December 9, 2021 at: https://www.uptodate.com/contents/peripheral-nerve-tumors
    Google Scholar
  • 3 Pilavaki M, Chourmouzi D, Kiziridou A, Skordalaki A, Zarampoukas T, Drevelengas A. Imaging of peripheral nerve sheath tumors with pathologic correlation: pictorial review. Eur J Radiol 2004; 52 (03) 229-239
    CrossrefPubMedGoogle Scholar
  • 4 Wang LM, Zhong YF, Zheng DF. et al. Intraneural perineurioma affecting multiple nerves: a case report and literature review. Int J Clin Exp Pathol 2014; 7 (06) 3347-3354
    PubMedGoogle Scholar
  • 5 Meyer A, Billings SD. What's new in nerve sheath tumors. Virchows Arch 2020; 476 (01) 65-80
    CrossrefPubMedGoogle Scholar
  • 6 MacCollin M, Chiocca EA, Evans DG. et al. Diagnostic criteria for schwannomatosis. Neurology 2005; 64 (11) 1838-1845
    CrossrefPubMedGoogle Scholar
  • 7 Kim DH, Murovic JA, Tiel RL, Moes G, Kline DG. A series of 397 peripheral neural sheath tumors: 30-year experience at Louisiana State University Health Sciences Center. J Neurosurg 2005; 102 (02) 246-255
    CrossrefPubMedGoogle Scholar
  • 8 Perrin RG, Guha A. Malignant peripheral nerve sheath tumors. Neurosurg Clin N Am 2004; 15 (02) 203-216
    CrossrefPubMedGoogle Scholar
  • 9 Yun JS, Lee MH, Lee SM. et al. Peripheral nerve sheath tumor: differentiation of malignant from benign tumors with conventional and diffusion-weighted MRI. Eur Radiol 2021; 31 (03) 1548-1557
    CrossrefPubMedGoogle Scholar
  • 10 Bhattacharyya AK, Perrin R, Guha A. Peripheral nerve tumors: management strategies and molecular insights. J Neurooncol 2004; 69 (1–3): 335-349
    CrossrefPubMedGoogle Scholar
  • 11 Kransdorf MJ. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 1995; 164 (02) 395-402
    CrossrefPubMedGoogle Scholar
  • 12 Ahlawat S, Chhabra A, Blakely J. Magnetic resonance neurography of peripheral nerve tumors and tumorlike conditions. Neuroimaging Clin N Am 2014; 24 (01) 171-192
    CrossrefPubMedGoogle Scholar
  • 13 Soldatos T, Fisher S, Karri S, Ramzi A, Sharma R, Chhabra A. Advanced MR imaging of peripheral nerve sheath tumors including diffusion imaging. Semin Musculoskelet Radiol 2015; 19 (02) 179-190
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 14 Woertler K. Tumors and tumor-like lesions of peripheral nerves. Semin Musculoskelet Radiol 2010; 14 (05) 547-558
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 15 Murphey MD, Smith WS, Smith SE, Kransdorf MJ, Temple HT. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics 1999; 19 (05) 1253-1280
    CrossrefPubMedGoogle Scholar
  • 16 Demehri S, Belzberg A, Blakeley J, Fayad LM. Conventional and functional MR imaging of peripheral nerve sheath tumors: initial experience. AJNR Am J Neuroradiol 2014; 35 (08) 1615-1620
    CrossrefPubMedGoogle Scholar
  • 17 Shimose S, Sugita T, Kubo T. et al. Major-nerve schwannomas versus intramuscular schwannomas. Acta Radiol 2007; 48 (06) 672-677
    CrossrefPubMedGoogle Scholar
  • 18 Kwon BC, Baek GH, Chung MS, Lee SH, Kim HS, Oh JH. Intramuscular neurilemoma. J Bone Joint Surg Br 2003; 85 (05) 723-725
    CrossrefPubMedGoogle Scholar
  • 19 Salunke AA, Chen Y, Tan JH. et al. Intramuscular schwannoma: clinical and magnetic resonance imaging features. Singapore Med J 2015; 56 (10) 555-557
    CrossrefPubMedGoogle Scholar
  • 20 McMenamin ME, Fletcher CDM. Expanding the spectrum of malignant change in schwannomas: epithelioid malignant change, epithelioid malignant peripheral nerve sheath tumor, and epithelioid angiosarcoma: a study of 17 cases. Am J Surg Pathol 2001; 25 (01) 13-25
    CrossrefPubMedGoogle Scholar
  • 21 Woodruff JM, Selig AM, Crowley K, Allen PW. Schwannoma (neurilemoma) with malignant transformation. A rare, distinctive peripheral nerve tumor. Am J Surg Pathol 1994; 18 (09) 882-895
    CrossrefPubMedGoogle Scholar
  • 22 Ahlawat S, Blakeley JO, Langmead S, Belzberg AJ, Fayad LM. Current status and recommendations for imaging in neurofibromatosis type 1, neurofibromatosis type 2, and schwannomatosis. Skeletal Radiol 2020; 49 (02) 199-219
    CrossrefPubMedGoogle Scholar
  • 23 Ahlawat S, Baig A, Blakeley JO, Jacobs MA, Fayad LM. Multiparametric whole-body anatomic, functional, and metabolic imaging characteristics of peripheral lesions in patients with schwannomatosis. J Magn Reson Imaging 2016; 44 (04) 794-803
    CrossrefPubMedGoogle Scholar
  • 24 Belakhoua SM, Rodriguez FJ. Diagnostic pathology of tumors of peripheral nerve. Neurosurgery 2021; 88 (03) 443-456
    CrossrefPubMedGoogle Scholar
  • 25 Macarenco RS, Ellinger F, Oliveira AM. Perineurioma: a distinctive and underrecognized peripheral nerve sheath neoplasm. Arch Pathol Lab Med 2007; 131 (04) 625-636
    CrossrefPubMedGoogle Scholar
  • 26 Lazarus SS, Trombetta LD. Ultrastructural identification of a benign perineurial cell tumor. Cancer 1978; 41 (05) 1823-1829
    CrossrefPubMedGoogle Scholar
  • 27 Shanthaveerappa TR, Bourne GH. Perineural epithelium: a new concept of its role in the integrity of the peripheral nervous system. Science 1966; 154 (3755): 1464-1467
    CrossrefPubMedGoogle Scholar
  • 28 Mentzel T, Dei Tos AP, Fletcher CDM. Perineurioma (storiform perineurial fibroma): clinico-pathological analysis of four cases. Histopathology 1994; 25 (03) 261-267
    CrossrefPubMedGoogle Scholar
  • 29 Balarezo FS, Muller RC, Weiss RG, Brown T, Knibbs D, Joshi VV. Soft tissue perineuriomas in children: report of three cases and review of the literature [corrected]. Pediatr Dev Pathol 2003; 6 (02) 137-141
    CrossrefPubMedGoogle Scholar
  • 30 Noonan VL, Greene DJ, Brodsky G, Kabani SP. Extraneural sclerosing perineurioma of the buccal mucosa: a case report and clinicopathologic review. Head Neck Pathol 2010; 4 (02) 169-173
    CrossrefPubMedGoogle Scholar
  • 31 Brock JE, Perez-Atayde AR, Kozakewich HP, Richkind KE, Fletcher JA, Vargas SO. Cytogenetic aberrations in perineurioma: variation with subtype. Am J Surg Pathol 2005; 29 (09) 1164-1169
    CrossrefPubMedGoogle Scholar
  • 32 Brand C, Pedro MT, Pala A. et al. Perineurioma: a rare entity of peripheral nerve sheath tumors. J Neurol Surg A Cent Eur Neurosurg 2021; May 24 (Epub ahead of print)
    PubMedGoogle Scholar
  • 33 Broski SM, Littrell LA, Howe BM, Folpe AL, Wenger DE. Extraneural perineurioma: CT and MRI imaging characteristics. Skeletal Radiol 2020; 49 (01) 109-114
    CrossrefPubMedGoogle Scholar
  • 34 Mauermann ML, Amrami KK, Kuntz NL. et al. Longitudinal study of intraneural perineurioma—a benign, focal hypertrophic neuropathy of youth. Brain 2009; 132 (Pt 8): 2265-2276
    CrossrefPubMedGoogle Scholar
  • 35 Harder A, Wesemann M, Hagel C. et al. Hybrid neurofibroma/schwannoma is overrepresented among schwannomatosis and neurofibromatosis patients. Am J Surg Pathol 2012; 36 (05) 702-709
    CrossrefPubMedGoogle Scholar
  • 36 Lang SS, Zager EL, Coyne TM, Nangunoori R, Kneeland JB, Nathanson KL. Hybrid peripheral nerve sheath tumor. J Neurosurg 2012; 117 (05) 897-901
    CrossrefPubMedGoogle Scholar
  • 37 Gupta G, Maniker A. Malignant peripheral nerve sheath tumors. Neurosurg Focus 2007; 22 (06) E12
    CrossrefPubMedGoogle Scholar
  • 38 Wasa J, Nishida Y, Tsukushi S. et al. MRI features in the differentiation of malignant peripheral nerve sheath tumors and neurofibromas. AJR Am J Roentgenol 2010; 194 (06) 1568-1574
    CrossrefPubMedGoogle Scholar
  • 39 Stasik CJ, Tawfik O. Malignant peripheral nerve sheath tumor with rhabdomyosarcomatous differentiation (malignant triton tumor). Arch Pathol Lab Med 2006; 130 (12) 1878-1881
    CrossrefPubMedGoogle Scholar
  • 40 Hrehorovich PA, Franke HR, Maximin S, Caracta P. Malignant peripheral nerve sheath tumor. Radiographics 2003; 23 (03) 790-794
    CrossrefPubMedGoogle Scholar
  • 41 Salamon J, Mautner VF, Adam G, Derlin T. Multimodal imaging in neurofibromatosis type 1-associated nerve sheath tumors. RoFo Fortschr Geb Rontgenstr Nuklearmed 2015; 187 (12) 1084-1092
    Artikel in Thieme ConnectPubMedGoogle Scholar
  • 42 Matsumine A, Kusuzaki K, Nakamura T. et al. Differentiation between neurofibromas and malignant peripheral nerve sheath tumors in neurofibromatosis 1 evaluated by MRI. J Cancer Res Clin Oncol 2009; 135 (07) 891-900
    CrossrefPubMedGoogle Scholar
  • 43 Li CS, Huang GS, Wu HD. et al. Differentiation of soft tissue benign and malignant peripheral nerve sheath tumors with magnetic resonance imaging. Clin Imaging 2008; 32 (02) 121-127
    CrossrefPubMedGoogle Scholar
  • 44 Ogose A, Hotta T, Morita T. et al. Diagnosis of peripheral nerve sheath tumors around the pelvis. Jpn J Clin Oncol 2004; 34 (07) 405-413
    CrossrefPubMedGoogle Scholar
  • 45 Pressney I, Khoo M, Khan R, Abernethy P, Hargunani R, Saifuddin A. Morphology of the entering and exiting nerve as a differentiating feature of benign from malignant peripheral nerve sheath tumours of the brachial plexus. Skeletal Radiol 2021; 50 (08) 1557-1565
    CrossrefPubMedGoogle Scholar
  • 46 Koike H, Nishida Y, Ito S. et al. Diffusion-weighted magnetic resonance imaging improves the accuracy of differentiation of benign from malignant peripheral nerve sheath tumors. World Neurosurg 2021
    PubMedGoogle Scholar
  • 47 Ahlawat S, Blakeley JO, Rodriguez FJ, Fayad LM. Imaging biomarkers for malignant peripheral nerve sheath tumors in neurofibromatosis type 1. Neurology 2019; 93 (11) e1076-e1084
    CrossrefPubMedGoogle Scholar
  • 48 Well L, Salamon J, Kaul MG. et al. Differentiation of peripheral nerve sheath tumors in patients with neurofibromatosis type 1 using diffusion-weighted magnetic resonance imaging. Neuro Oncol 2019; 21 (04) 508-516
    CrossrefPubMedGoogle Scholar
  • 49 Ahlawat S, Fayad LM. Imaging cellularity in benign and malignant peripheral nerve sheath tumors: utility of the “target sign” by diffusion weighted imaging. Eur J Radiol 2018; 102: 195-201
    CrossrefPubMedGoogle Scholar