| Popis: |
Mass lesions of the peripheral nervous system present an interesting diagnostic challenge as well as a number of obstacles to their management. The range of pathology of these lesions spans from completely benign to aggressively malignant, while optimal management of these lesions ranges from non-operative to radical resection. Operative management is complicated by their frequent involvement in major mixed nerves, as well as their potential location in close proximity to major blood vessels and the spinal cord. Operative resection that results in a major postoperative deficit is unacceptable for the benign lesions. Thus, understanding the principles for diagnosing and managing these relatively rare lesions is vitally important despite there being little guidance on their management in the literature. Optimal management requires a thorough understanding of the breadth of potential pathologies, of the operative anatomy, and comfort with the principles of resection of these lesions. Because management often requires adjuvant physical, pain management, chemo-, or radiation therapies, a multidisciplinary approach is often necessary. The differential diagnosis of mass lesions of the peripheral nervous system includes but is not limited to schwannoma, neurofibroma, perineurioma, malignant peripheral nerve sheath tumour, intraneural lipoma, fibrolipomatous hamartoma (lipomatosis of nerve), ganglion cyst, desmoid tumour, sarcoidosis, and metastatic disease. This chapter reviews the evaluation and management principles of these mass lesions. |
