Fibrosarcoma Perineural

Currently, in oncology more and more attention is paid to the primary focus of the disease. In other words, a neoplasm from the point of view of metastasis - which either does not penetrate through intercellular connections (infiltrating growth), or which are adjacent or close in location to the main neurovascular pathways

Among tumors of peripheral nerves, the most malignant are the so-called “malignant” neuromas and, above all, the so-called Pinner's fascial neuroangiomatous syndrome. Adercholimoblastomas also grow as metastases due to recent tumor growth.

But there is another idea about the benign nature of tumors of the peripheral nervous system. Based on a number of studies, they have only an involuting (scarring) effect on the nerve elements and an anomic effect on adjacent tissues, which can cause symptoms of compression and primary neoplastic growth. These tumors are called, for example, simply benign neuromas or embryonal perineural neoplasms. If such tumors multiply “foreignly” within themselves, this causes scars that, when standing for a long time, tighten nearby blood vessels. In addition, they may contain some zones that stimulate blood flow in the neighboring area. In the case of such a phenomenon, there is no disorder, and she can stop growing on her own. This may slow the progression of symptoms or even stop it (in some cases). Thus, “painless” progressive (benign) tumors of peripheral nerves, characterized by slow tissue growth, never destroy nerve fibers. It is important that they are not traumatically displaced, and since we are talking about so-called fibroids, this can lead to disruption of the nutrition of the limb and the associated nerve. Although these fibrosarcomas may initially be inactive, over time there is often a clinically noticeable portion of nerve damage due to stretching, damage, fluid loss, or sepsis obstruction. The most common symptom that results is stiffness. In many patients, when this occurs, it is not noticed at all.

Contents - Definition - Etymology - Distribution - Classification - Clinical picture - Diagnosis - Treatment - Prognosis and prevention - References

Definition Fibrosarcoma of peripheral nerves or fibrovascular lipoma is a rare tumor of fibrous structures, degenerated from its own vessels and located between the fibrous structures of adipose tissue. A fibrovascular tumor nodule can be single, but usually multiple nodes are formed. Occurs mainly in older people. The tumor is not actually a lipoma. Distinctive histochemical features of tumor fibrils are the absence of lipids and glycogen in the presence of neutral mucin and the LPL synthase complex. Nissl staining identifies surface fibers, and von Kruckenberg staining reveals internal connections. Pain, swelling and asymmetry are characteristic of nerve pathology.

Etymology The tumor is called fibroarmon from the Greek “fibros” - fiber and the Latin “sarcoma” - tumor. The name of the cell was mistakenly pronounced due to the similarity of the phrase “fibrosarcoma” with the phrase “sarcoma, tumor”. Distribution Usually located perineurally

Classification Described by location. – Pleural – Spinal – Cutaneous – Rarely submucosal – Cardiovascular – Perinodation

According to histological structure: – Vascular – Muscular – Fibrous – Heterogeneous (includes nodes with signs of vascular, muscular and fibrous infiltration) – – Solitary – Multiple

Clinical picture The clinical picture is similar; it can manifest itself as increased pain symptoms in the lumbar region, dull or sharp characteristic pain or paresthesia in the affected area and the formation of exophytic formations. Sometimes there is compression of the nerve structures (nerve roots, spinal cord) in the affected area. In elderly and very young people, it can create a false picture of intervertebral osteochondrosis or radiculitis, which leads to erroneous diagnosis and prescription of appropriate treatment.