Ahmet SALDUZ, Arda ÇINAR, Mehmet ALP, Emre ÖZMEN, Ömer Naci ERGİN, İbrahim Levent ERALP

SİNİR BASISI YAPAN BENİGN KEMİK VE YUMUŞAK DOKU TÜMÖRLERİ: CERRAHİ TEDAVİ SONUÇLARIMIZ VE LİTERATÜR DERLEMESİ

Amaç: Benign kemik ve yumuşak doku tümörlerinin oluşturduğu sinir basıları nadir bir periferik nöropati sebebidir. Bu çalışmada kliniğimizde benign kemik ve yumuşak doku tümörü nedeniyle oluşmuş periferik nöropatili hastalarda uyguladığımız cerrahi tedavilerin sonuçlarını bildirmeyi amaçladık.Hastalar ve Metod: 2010 ve 2015 yılları arasında kliniğimizde tedavi edilen benign tümöre bağlı sinir basısı oluşmuş 16 hasta çalışmaya dahil edildi. Ortalama yaşları 28 (2,5- 55) idi. Altı hastada fibular sinire bası yapan fibula başı osteokondromu tespit edildi. Geriye kalan 10 hastada çeşitli yerlerde çeşitli yumuşak doku tümöleri tespit edildi. Hastalar ilk başvuruda pür duyusal, pür motor yada her iki nörolojik deficit ile başvurdu. Ortalama takip süremiz 38 (11-120) ay idi.Sonuçlar: Tüm hastalar tümörün cerrahi eksizyonu ve ek olarak vitamin takviyesi ile tedavi edildi. Bütün hastalar ameliyat sonrası ortalama 1 ay içerisinde motor ve duyusal fonksiyonu geri kazandılar. Hastaların son takiplerinde nüks izlenmedi.Çıkarımlar: Periferik nöropati ayırıcı tanısında sinir basısı yapan tümörler unutulmamalıdır. Erken tanı uygun cerrahi tedavi ile mükemmel sonuç elde edilebilir. Anahtar kelimeler: Nöropati; bening tümörler; osteokondroma; sinir basısı.

Anahtar Kelimeler:

Nöropati, bening tümörler, osteokondroma, sinir basısı

BENIGN BONE AND SOFT-TISSUE TUMORS OF THE EXTREMITIES CAUSING COMPRESSION OF NERVES

Objective: Compression of nerves by benign bone and soft tissue tumors comprise an uncommon cause of peripheral neuropathies. We aim to present cases of peripheral nerve compression due to benign bone and soft tissue tumors treated in our clinic.Methods: We report a case series with a total of 16 patients who were treated in our clinic between 2010 and 2015. Mean age of the patients was 28 (2,5-55). Six of the patients had osteochondroma of the fibular head. The remaining 10 patients had various soft tissue tumors localized at different locations. Patients presented with pure sensory, pure motor, or mixed sensory and motor deficits. Mean duration of follow-up was 38 (11-120) months. Results: All patients underwent surgical excision and were treated additionally with vitamin supplements. All patients regained function within 1 month post-operatively. There was no recurrence at the end of the follow-up.Conclusions: Compression by tumors should be included in the differential diagnosis and work-up of peripheral neuropathies. Results are excellent with prompt diagnosis and surgical intervention. Keywords: Benign tumors; nerve compression; neuropathies; osteochondorma.

Keywords:

Benign tumors, nerve compression, neuropathies,

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1. Allagui M, Maghrebi S, Touati B, Koubaa M, Hadhri R, Hamdi MF, Abid A. Posterior interosseous nerve syndrome due to intramuscular lipoma. European Orthopaedics and Traumatology 2014;5:75-9.
2. Dailiana ZH, Bougioukli S, Varitimidis S, Kontogeorgakos V, Togia E, Vlychou M, Malizos KN. Tumors and tumor-like lesions mimicking carpal tunnel syndrome. Archives of Orthopaedic and Trauma Surgery 2014;134:139-44.
3. El Hyaoui H, Hassoun J, Garch A, Kassimi EH, El Fatimi A. Compression of the posterior interosseous nerve by a deep lipoma. Joint Bone Spine 2014;3:265.
4. Fazilleau F, Williams T, Richou J, Sauleau V, Le Nen D. Median Nerve Compression in Carpal Tunnel Caused by a Giant Lipoma. Case reports in Orthopedics 2014 Article ID 654934, 5 pages.
5. Herskovitz S, Scelsa SN, Schaumburg HH. Focal Neuropathies: Nerve Injuries, Entrapments, and other Mononeuropathies in Peripheral neuropathies in clinical practice. Oxford University Press Oxford, City, 2010; Chepter:18, page: 312-346.
6. Katirji MB, Wilbourn AJ. Common peroneal mononeuropathy A clinical and electrophysiologic study of 116 lesions. Neurology 1988;38:1723.
7. Kohyama K, Sugiura H, Yamada K, Hyodo I, Kato H, Kamei Y. Posterior interosseous nerve palsy secondary to pigmented villonodular synovitis of the elbow: Case report and review of literature. Orthopaedics & Traumatology: Surgery & Research 2013;99: 247-25.
8. Martínez-Villén G, Badiola J, Alvarez-Alegret R, Mayayo E. Nerve compression syndromes of the hand and forearm associated with tumours of non-neural origin and tumour-like lesions. Journal of Plastic, Reconstructive & Aesthetic Surgery 2014;67: 828-36.
9. Pomeroy G, Wilton J, Anthony S. Entrapment Neuropathy About the Foot and Ankle: An Update. Journal of the American Academy of Orthopaedic Surgeons 2015;23:58-66.
10. Sakamoto A, Yoshida T, Mitsuyasu H, Iwamoto Y. Lipoma causing posterior interosseous nerve palsy or superficial radial nerve paraesthesia. Journal of Hand Surgery (European Volume) 2011;36:76-7. 11. Singh G, Kumar VP. Neuroanatomical basis for the tarsal tunnel syndrome. Foot & ankle international 2012;33: 513-8.
12. Sirrajelhak M, Fnini S, Arssi M, Garch A. [Compression of the superficial branch of the radial nerve by a synovial ganglion of the elbow (about one case and literature review)]. Chirurgie de la main 2013;32:255-7.
13. Wang B, Zhao Y, Lu A, Chen C. Ulnar nerve deep branch compression by a ganglion: A review of nine cases. Injury 2014;45:1126-30.
14. Yazid BM, Tan BC, Das S, Hassan S, Subanesh S. Compression neuropathy of the common peroneal nerve secondary to a ganglion cyst. La Clinica Terapeutica 2010;162: 549-52.