The Malignant Tumors of the Peripheral Nerves

Abstract

There are two groups of malignant tumors which develop in peripheral nerves: those which have the morphological characteristics of malignant fibroblastic tumors and those which are epithelial in type and reproduce in a more or less recognizable form embryonal or adult neuro-ectodermal structures. Both classes develop from structures in the nerve sheaths but not from the nerve fibers themselves.

Of the first group, which is by far the more common, the great majority develop in individuals suffering from von Recklinghausen's disease. It will be shown that most of these tumors may properly be called fibrosarcomas, while a few with slightly different morphology are better termed malignant neurofibromas. All of these tumors are characterized by persistent growth, with a marked tendency to reappear after attempts at removal, and a great many have proved fatal, although metastases are uncommon. The second group of tumors is represented by a very few cases, each one of which differs from the others. The only features which are common to all of them are a probable common origin from neuroectoderm and the fact that all are malignant. It is the purpose of this communication to present the evidence which seems to support the above statements, derived from an analysis of published cases and from 8 new cases which have come to the writer's attention. For the purposes of this discussion the term “peripheral nerves” includes not only the derivatives of the spinal nerve roots but also the extradural portions of the cranial nerves, excluding the optic nervc. They are extremely radioresistant.

The second group of tumors is represented by a very few cases, each one of which differs from the others. The only features which are common to all of them are a probable common origin from neuroectoderm and the fact that all are malignant.