Malignant peripheral nerve sheath tumor in the brachial plexus: A case report

Malignant peripheral nerve sheath tumor (MPNST) is a kind of rare neurogenic tumor with high aggressiveness and poor prognosis. Challenges exist in diagnosis and management. To date, complete surgical resection with wide negative margins is the optimal standard of care for MPNST, and the role of chemotherapy and radiotherapy is undetermined. Due to the rarity of this tumor, there are few reports, and clinicians do not know enough about it. Here we report a rare case of a 49-yr-old male, with no family history of neurofibromatosis, who presented with a 1-mo history of a mass in the right supraclavicular region, accompanied by a mild sensorimotor deficit of the right upper limb. Radiological imaging revealed a well-defined mass (diameter of 4.0 cm) stretching from the interscalene to the supraclavicular region. Intraoperative observation showed that the mass enclosed by the epineurium was located in the upper trunk of the brachial plexus. After surgical resection, the mass was histologically confirmed to be MPNST. Adjuvant radiotherapy (60 Gy) was given after surgery, and there were no local recurrence and distant metastasis after a 6-month follow-up.