Artikel
Peripheral nerve tumours – difficult to diagnose?
Periphere Nerventumore – schwierig zu diagnostizieren?
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Veröffentlicht: | 4. Juni 2021 |
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Gliederung
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Objective: Peripheral nerve tumors are rare and sometimes difficult to diagnose. Despite recent advances in diagnostic tools and the more commonly use of ultrasound, MRI and electrophysiology, time until diagnosis of peripheral nerve tumors is quite long and they can be mistreated prior to diagnosis.
We therefore tried to analyze the frequency of misdiagnosed patients, treated as a spinal canal stenosis or a disc herniation.
Methods: Retrospective evaluation of patients treated in our department due to a peripheral nerve tumor between 2012 until 2018. Demographic, neurological symptoms, initial diagnosis, time of “false” treatment were analyzed.
Results: In total, 116 patients were treated (60 female, mea age: 50.3 ± 15.3 years of age). 43 neurinoma (37.1%), 18 neurofibroma (15.5%), 17 ganglioma (14.7%) 9 lipoma (7.8%) and 4 perineurioma (3.4%) analyzed. Peroneal nerve (n=21), sciatic nerve (n=11), ulnar nerve (n=11) and tibial nerve (n=10) were the most affected locations. First symptom was mainly pain (49.1%) followed by palpable lesion (27.6%).
False diagnosis and false treatment prior to diagnostic of a peripheral nerve tumor were seen in 26 patients (22.4%). Misdiagnosis was not significantly affected by the tumor (p=0.149) or the location of the tumor (p=0.233). False diagnose was detected in patients suffering from pain as the first symptom in majority (17/26, p=0.0001).
Conclusion: Symptoms of peripheral nerve tumors can easily be misinterpreted, mimicking degenerative spinal diseases, especially if pain is the first symptom.