Background: Peripheral nerve tumors are mostly benign tumors, however their excision can lead to profound functional deficit.  While physical examination, imaging, and electrodiagnostic studies can strongly suggest the diagnosis of a peripheral nerve tumor, surgical management is not as straightforward.  This prospective study evaluates a treatment strategy that is reliable, safe, and offers maximal functional recovery.

Methods: Twenty patients with peripheral nerve tumors were treated using a uniform surgical paradigm between 2003 and 2007.  Surgical tumor excision and reconstruction was performed in a single stage.  No biopsies were performed.  Nerve fascicles were dissected off of the tumor under magnification, and sacrificed nerve fascicles were reconstructed using nerve conduits. Patients were followed clinically from six to twenty-four months, and neuropathic pain and functional outcome were assessed. 

Results: All twenty consecutive patients had neuropathic pain in the distribution of the affected nerve before tumor excision; only one patient had pain that persisted postoperatively.  Seventeen of the twenty patients had complete functional recovery following nerve reconstruction.  No perioperative complications occurred.

Conclusions: Peripheral nerve tumors require highly-specialized surgical care to ensure optimal functional results.  Single-stage tumor excision under magnification, with immediate reconstruction, permits functional recovery and minimizes scarring. Biopsy is indicated only if quick tumor growth is observed, or if imaging suggests malignancy.  Functional recovery and complete pain relief should be expected in the majority of cases, with minimal morbidity.