Schwannomas of the Hand and Wrist: Long-Term Results and Review of the Literature

Abstract

Purpose. To review the long-term results of 14 cases of histopathologically confirmed schwannoma of the hand and wrist treated with intracapsular tumour removal. Methods. All operations were performed under loupe magnification and microsurgical dissection, and the tumour was removed after capsular (including endoneurium) incision. Patients were assessed for any residual symptoms. Sensory testing of light touch and pain was carried out. Results. The mean age of the patients at the time of operation was 38.4 years (range, 11–78 years), and the mean follow-up period was 12.6 years (range, 3–36 years). Ten of the tumours were located in the median nerve distribution, whereas 4 in the ulnar nerve distribution. Four tumours were at the wrist level, 3 at the palm level, and 7 at the digital level (3 in the index finger). Only 5 patients were correctly diagnosed preoperatively. Neurological loss was not recovered in one patient in whom the tumour was resected with the digital nerve. No recurrence or muscle atrophy was noted at the latest follow-up. Conclusion. Meticulous dissection with magnification can achieve complete tumour removal without neurological loss or recurrence. Intracapsular tumour removal provides good results with a low complication rate.