The Role of Pre-Operative Biopsy in Malignant Peripheral Nerve Sheath Tumours: A Review and Retrospective Series with a Management Algorithm from a Single-Center Experience.

IF 3 Q2 CLINICAL NEUROLOGY
Francesca Vincitorio, Leonardo Bradaschia, Enrico Lo Bue, Alice Antico, Paolo Titolo, Bruno Battiston, Diego Garbossa, Fabio Cofano
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引用次数: 0

Abstract

Background/Objectives: Peripheral nerve tumours are commonly encountered in clinical practice. Although most are benign, a subset can exhibit aggressive and invasive behaviour, evolving into malignant peripheral nerve sheath tumours (MPNSTs). Due to their rarity and overlapping features with benign lesions, MPNSTs are frequently misdiagnosed during the initial evaluation. Preoperative biopsy may aid in distinguishing malignant from benign lesions. This single-center study aimed to develop and validate a diagnostic algorithm-based on a systematic literature review and institutional case series-to assess the role of preoperative biopsy in the diagnostic workflow. Methods: A systematic review of the literature was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, covering the period from 1998 to 2024. Additionally, a retrospective case series of patients with peripheral nerve lesions treated at the authors' institution between January 2018 and June 2024 was analysed. Results: Forty-eight articles met the inclusion criteria and were categorized into five key domains: radiological features of MPNSTs, associated risk factors and genetic conditions, the role of preoperative biopsy, use of radiotherapy, and general clinical management strategies. The proposed diagnostic algorithm was applied to a series of 36 patients, four of whom met the criteria for preoperative biopsy. In three of these cases, early diagnosis of MPNSTs was achieved. Conclusions: Preoperative biopsy appears to be a safe and cost-effective tool for the early identification of MPNSTs. Early diagnosis may facilitate the use of neoadjuvant therapies-such as radiotherapy or chemotherapy-potentially enabling more radical surgical resection and improving overall patient outcomes.

术前活检在恶性周围神经鞘肿瘤中的作用:回顾和回顾性系列与单中心经验的管理算法。
背景/目的:周围神经肿瘤是临床上常见的肿瘤。虽然大多数肿瘤是良性的,但有一部分肿瘤可以表现出侵略性和侵袭性行为,演变成恶性周围神经鞘肿瘤(MPNSTs)。由于其罕见性和与良性病变重叠的特征,mpnst在最初的评估中经常被误诊。术前活检有助于区分良性和恶性病变。本单中心研究旨在开发和验证一种基于系统文献综述和机构病例系列的诊断算法,以评估术前活检在诊断工作流程中的作用。方法:根据PRISMA(系统评价和荟萃分析首选报告项目)指南对1998年至2024年期间的文献进行系统评价。此外,对2018年1月至2024年6月期间在作者所在机构接受治疗的周围神经病变患者的回顾性病例系列进行了分析。结果:48篇文章符合纳入标准,并被分为五个关键领域:MPNSTs的放射学特征、相关危险因素和遗传条件、术前活检的作用、放疗的使用和一般临床管理策略。将所提出的诊断算法应用于36例患者,其中4例患者符合术前活检标准。在这些病例中,有3例获得了早期诊断。结论:术前活检似乎是一种安全且经济有效的早期诊断mpnst的工具。早期诊断可能有助于使用新辅助治疗,如放疗或化疗,有可能实现更彻底的手术切除并改善患者的整体预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Neurology International
Neurology International CLINICAL NEUROLOGY-
CiteScore
3.70
自引率
3.30%
发文量
69
审稿时长
11 weeks
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