Advertisement

Two case reports of fair lower limb function after sciatic nerve sacrifice for the treatment of a malignant peripheral nerve sheath tumor

  • Akiyoshi Shimatani
  • Masanari Aono
  • Manabu Hoshi
  • Naoto Oebisu
  • Tadashi Iwai
  • Naoki Takada
  • Hiroaki Nakamura
Case report
  • 8 Downloads

Abstract

Wide resection for malignant soft tissue tumors may require resection of a major nerve. When a limb salvage procedure is selected in these cases, the anticipated functional outcome of the procedure must be clearly discussed with the patient, as recovery of normal function cannot be expected. In this report, we describe our surgical management of two cases of malignant peripheral nerve sheath tumor, a 58-year-old man and a 10-year-old girl, requiring a limb salvage procedure with sacrifice of the sciatic nerve. Although both patients required a short-leg brace for walking, because of a drop foot, both patients reported satisfactory functional results and were able to perform their activities of daily living with only slight difficulties. Based on our experience, limb salvage surgery can be considered for the treatment of malignancies involving the sciatic nerve, with fair functional outcomes expected.

Keywords

MPNST Limb salvage surgery Sciatic nerve Function 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Informed consent

The patients and/or their families were informed that data from the case would be submitted for publication and provided their consent.

References

  1. 1.
    Enneking WF, Dunham W, Gebhardt MC et al (1993) A system for functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:241–246Google Scholar
  2. 2.
    Ng VY, Scharschmidt TJ, Mayerson JL et al (2013) Incidence and survival in sarcoma in the United States: a focus on musculoskeletal lesions. Anticancer Res 33:2597–2604PubMedGoogle Scholar
  3. 3.
    Farid M, Demicco EG, Garcia R et al (2014) Malignant peripheral nerve sheath tumors. Oncologist 19:193–201CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Porter DE, Prased V, Foster L et al (2009) Survival in malignant peripheral nerve sheath tumors: a comparison between sporadic and neurofibromatosis type-1 associated tumors. Sarcoma 2009:756395CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Evans DG, Baser ME, McGaughran J et al (2002) Malignant peripheral nerve sheath tumors in neurofibromatosis 1. J Med Genet 39:311–314CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Hohenberger P, Allenberg JR, Schlag PM et al (1999) Results of surgery and multimodal therapy for patients with soft tissue sarcomas invading to vascular structures. Cancer 85:396–408CrossRefPubMedGoogle Scholar
  7. 7.
    Spiro IJ, Rosenberg AE, Springield D et al (1995) Combined surgery and radiation therapy for limb preservation in soft tissue sarcoma of the extremity: the Massachusetts General Hospital experience. Cancer Invest 13:86–95CrossRefPubMedGoogle Scholar
  8. 8.
    Williard WC, Hajdu SI, Casper ES et al (1992) Comparison of amputation with limb sparing operations for adult soft tissue sarcoma of extremity. Ann Surg 215:269–275CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Nambisan RN, Rao U, Moore R et al (1984) Malignant soft tissue tumors of nerve sheath origin. J Surg Oncol 25:268–272CrossRefPubMedGoogle Scholar
  10. 10.
    Fuchs B, Davis AM, Wunder JS et al (2001) Sciatic nerve resection in the thigh.: a functional evaluation. Clin Orthop Relat Res 382:34–41CrossRefGoogle Scholar
  11. 11.
    Davis AM, Devlin M, Griffin AM et al (1999) Functional outcome in amputation versus limb-sparing of patients with lower extremity sarcoma. Arch Phys Med Rehabil 80:615–618CrossRefPubMedGoogle Scholar
  12. 12.
    Jacob Bickels JC, Witting Y, Kollender et al (2002) Sciatic nerve resection. Clin Orthop Relat Res 399:201–204CrossRefGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryOsaka City University Graduate School of MedicineOsakaJapan
  2. 2.Department of Orthopedic SurgeryOsaka City General HospitalOsakaJapan

Personalised recommendations