Tumors and Tumor-Like Lesions of Peripheral Nerves

ABSTRACT

The diagnosis of a peripheral nerve tumor can often be suggested on imaging. Direct continuity with a neural structure or location along a typical nerve distribution, shape, and intrinsic magnetic resonance (MR) signal characteristics represent the most important signs in this regard. Although several nonneoplastic nerve lesions can be specifically diagnosed by MR imaging, benign and malignant neoplasms of peripheral nerves can usually not be distinguished with confidence. This article reviews the MR imaging appearance, clinical and pathological features of schwannoma, localized neurofibroma, plexiform neurofibroma, intraneural perineurioma, fibrolipomatous hamartoma, nerve sheath ganglion, traumatic neuroma, malignant peripheral nerve sheath tumor, and secondary malignant neoplasms of peripheral nerves. Typical findings are illustrated on the basis of histologically confirmed cases.

KEYWORDS

Peripheral nerves - neurogenic tumors - MR soft tissue imaging - soft tissue neoplasms - MR nerve imaging

REFERENCES

• 1 Weiss SW, Goldblum JR Enzinger and Weiss's Soft Tissue Tumors. 4th ed. St. Louis, MO; Mosby 2001
• 2 Kransdorf M J. Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location.  AJR Am J Roentgenol. 1995;  164(2) 395-402
• 3 Kransdorf M J. Malignant soft-tissue tumors in a large referral population: distribution of diagnoses by age, sex, and location.  AJR Am J Roentgenol. 1995;  164(1) 129-134
• 4 Kim D H, Murovic J A, Tiel R L, Moes G, Kline D G. A series of 146 peripheral non-neural sheath nerve tumors: 30-year experience at Louisiana State University Health Sciences Center.  J Neurosurg. 2005;  102(2) 256-266
• 5 Murphey M D, Smith W S, Smith S E, Kransdorf M J, Temple H T. From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation.  Radiographics. 1999;  19(5) 1253-1280
• 6 Vilanova J C, Woertler K, Narváez J A et al.. Soft-tissue tumors update: MR imaging features according to the WHO classification.  Eur Radiol. 2007;  17(1) 125-138
• 7 Isobe K, Shimizu T, Akahane T, Kato H. Imaging of ancient schwannoma.  AJR Am J Roentgenol. 2004;  183(2) 331-336
• 8 Suh J S, Abenoza P, Galloway H R, Everson L I, Griffiths H J. Peripheral (extracranial) nerve tumors: correlation of MR imaging and histologic findings.  Radiology. 1992;  183(2) 341-346
• 9 Varma D G, Moulopoulos A, Sara A S et al.. MR imaging of extracranial nerve sheath tumors.  J Comput Assist Tomogr. 1992;  16(3) 448-453
• 10 Bhargava R, Parham D M, Lasater O E, Chari R S, Chen G, Fletcher B D. MR imaging differentiation of benign and malignant peripheral nerve sheath tumors: use of the target sign.  Pediatr Radiol. 1997;  27(2) 124-129
• 11 Jee W H, Oh S N, McCauley T et al.. Extraaxial neurofibromas versus neurilemmomas: discrimination with MRI.  AJR Am J Roentgenol. 2004;  183(3) 629-633
• 12 Lin J, Martel W. Cross-sectional imaging of peripheral nerve sheath tumors: characteristic signs on CT, MR imaging, and sonography.  AJR Am J Roentgenol. 2001;  176(1) 75-82
• 13 Sullivan T P, Seeger L L, Doberneck S A, Eckardt J J. Case report 828: plexiform neurofibroma of the tibial nerve invading the medial and lateral gastrocnemius muscles and plantaris muscle.  Skeletal Radiol. 1994;  23(2) 149-152
• 14 Woodruff J M. The pathology and treatment of peripheral nerve tumors and tumor-like conditions.  CA Cancer J Clin. 1993;  43(5) 290-308
• 15 Mauermann M L, Amrami K K, Kuntz N L et al.. Longitudinal study of intraneural perineurioma—a benign, focal hypertrophic neuropathy of youth.  Brain. 2009;  132(Pt 8) 2265-2276
• 16 Simmons Z, Mahadeen Z I, Kothari M J, Powers S, Wise S, Towfighi J. Localized hypertrophic neuropathy: magnetic resonance imaging findings and long-term follow-up.  Muscle Nerve. 1999;  22(1) 28-36
• 17 Marom E M, Helms C A. Fibrolipomatous hamartoma: pathognomonic on MR imaging.  Skeletal Radiol. 1999;  28(5) 260-264
• 18 Van Breuseghem I, Sciot R, Pans S, Geusens E, Brys P, De Wever I. Fibrolipomatous hamartoma in the foot: atypical MR imaging findings.  Skeletal Radiol. 2003;  32(11) 651-655
• 19 Boutin R D, Pathria M N, Resnick D. Disorders in the stumps of amputee patients: MR imaging.  AJR Am J Roentgenol. 1998;  171(2) 497-501
• 20 Singson R D, Feldman F, Staron R, Fechtner D, Gonzalez E, Stein J. MRI of postamputation neuromas.  Skeletal Radiol. 1990;  19(4) 259-262
• 21 Zanetti M, Ledermann T, Zollinger H, Hodler J. Efficacy of MR imaging in patients suspected of having Morton's neuroma.  AJR Am J Roentgenol. 1997;  168(2) 529-532
• 22 Woertler K. Soft tissue masses in the foot and ankle: characteristics on MR imaging.  Semin Musculoskelet Radiol. 2005;  9 227-242
• 23 Weishaupt D, Treiber K, Kundert H P et al.. Morton neuroma: MR imaging in prone, supine, and upright weight-bearing body positions.  Radiology. 2003;  226(3) 849-856
• 24 Zanetti M, Strehle J K, Zollinger H, Hodler J. Morton neuroma and fluid in the intermetatarsal bursae on MR images of 70 asymptomatic volunteers.  Radiology. 1997;  203(2) 516-520
• 25 Zou C, Smith K D, Liu J et al.. Clinical, pathological, and molecular variables predictive of malignant peripheral nerve sheath tumor outcome.  Ann Surg. 2009;  249(6) 1014-1022
• 26 Porter D E, Prasad V, Foster L, Dall G F, Birch R, Grimer R J. Survival in malignant peripheral nerve sheath tumours: a comparison between sporadic and neurofibromatosis type 1-associated tumours.  Sarcoma. 2009;  2009 756395
• 27 Ducatman B S, Scheithauer B W, Piepgras D G, Reiman H M, Ilstrup D M. Malignant peripheral nerve sheath tumors. A clinicopathologic study of 120 cases.  Cancer. 1986;  57(10) 2006-2021
• 28 Li C S, Huang G S, Wu H D et al.. Differentiation of soft tissue benign and malignant peripheral nerve sheath tumors with magnetic resonance imaging.  Clin Imaging. 2008;  32(2) 121-127
• 29 Misdraji J, Ino Y, Louis D N, Rosenberg A E, Chiocca E A, Harris N L. Primary lymphoma of peripheral nerve: report of four cases.  Am J Surg Pathol. 2000;  24(9) 1257-1265
• 30 Quiñones-Hinojosa A, Friedlander R M, Boyer P J, Batchelor T T, Chiocca E A. Solitary sciatic nerve lymphoma as an initial manifestation of diffuse neurolymphomatosis. Case report and review of the literature.  J Neurosurg. 2000;  92(1) 165-169
• 31 Descamps M J, Barrett L, Groves M et al.. Primary sciatic nerve lymphoma: a case report and review of the literature.  J Neurol Neurosurg Psychiatry. 2006;  77(9) 1087-1089
• 32 Stillman M J, Christensen W, Payne R, Foley K M. Leukemic relapse presenting as sciatic nerve involvement by chloroma (granulocytic sarcoma).  Cancer. 1988;  62(9) 2047-2050
• 33 Noh B W, Park S W, Chun J E, Kim J H, Kim H J, Lim M K. Granulocytic sarcoma in the head and neck: CT and MR imaging findings.  Clin Exp Otorhinolaryngol. 2009;  2(2) 66-71
• 34 Ooi G C, Chim C S, Khong P L et al.. Radiologic manifestations of granulocytic sarcoma in adult leukemia.  AJR Am J Roentgenol. 2001;  176(6) 1427-1431