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KMID : 0613320030090020148
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Journal of the Korean Bone and Joint Tumor Soceity
2003 Volume.9 No. 2 p.148 ~ p.154
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Schwannoma of the Extremities
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Park Won-Jong
Rhee Seung-Koo
Kang Yong-Koo
Lee An-Hi
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Abstract
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Purpose: To correlate the significant MRI findings and histologic features of the Schwannoma of the extremities and to review the clinical characteristic and the result of the surgical enucleation.
Materials and Methods: 67 patients with pathologically proven Schwannoma of the extremities, who were surgically treated at our institutes between January 1996 and June 2002, were selected for this study. The clinical records, EMG, MRI and histologic findings were reviewed. Age of the patients ranged from 8 to 75 years with average of 44.7 years. Mean follow-up period was 9.7 months with raging from 3 months to 46 months.
Results: On MRI, Schwannoma shows a well-demarcated fusiform mass with a low to intermediate signal intensity on T1-weighted images and high signal intensity on T2-weighted images, which is connected to parent nerve. A target pattern with peripheral hyperintensive rim and central low intensity on T2-weighted images was seen in 6 cases (15%), and fasciculation pattern with inhomogenous intensity in the hyperintensity on T2-weighted images was observed in 24 cases (62%). Various degree of cystic degeneration was discovered in 25 cases (64%). Postoperative complications include tingling sense or radiating pain in 5 patients, paresthesia in 2 patients, nerve palsy in 2 patients, but all of the complications were recovered during followup period. There were no local recurrence or malignant change.
Conclusion: MRI demonstrates characteristic findings of Schwannoma, and very useful tool for preoperative diagnosis and planning of surgery. Exact preoperative diagnosis and meticulous enucleation are enough option of treatment.
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KEYWORD
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Extremities, Schwannoma, Nurilemoma, MRI, Enucleation
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