Two-year Local and Distant Control of Malignant Peripheral Nerve Sheath Tumor (MPNST) in NF1 Patients After Multiple Recurrences: A Case Report
Malignant Peripheral Nerve Sheath Tumor in NF1
Abstract
Malignant peripheral nerve sheath tumors (MPNSTs) are rare, biologically high-grade sarcomas that tend to recur and metastasize. The known risk factors for MPNSTs include neurofibromatosis type 1, highly aggressive MPNSTs, and dismal survival outcomes. Multimodality therapies, including surgical resection, radiotherapy, chemotherapy, targeted therapy, and combination therapy, are available. This case report describes a young woman with NF1 who was referred to us with a history of three local recurrences of MPNSTs in the proximal part of her left thigh after several surgical attempts. Successful local and distant control was achieved via preoperative radiotherapy and chemotherapy prior to the latest surgery. With preoperative RT and chemotherapy, more long-term and successful local and distant control was achieved, particularly in high-risk NF1- associated MPNST patients with a history of recurrence. Trials with larger sample sizes may show improvements in local control (LC), disease-free survival (DFS), and overall survival (OS) with neoadjuvant interventions in such patients.
[2] Anghileri M, Miceli R, Fiore M, Mariani L, Ferrari A, Mussi C, et al. Malignant peripheral nerve sheath tumors: prognostic factors and survival in a series of patients treated at a single institution. Cancer. 2006 Sep 1;107(5):1065-74. https://doi. org/10.1002/cncr.22098
[3] Reilly KM, Kim A, Blakely J, Ferner RE, Gutmann DH, Legius E, et al. Neurofibromatosis type 1-associated MPNST state of the science: outlining a research agenda for the future. J Natl Cancer Inst. 2017 Aug 1;109(8):djx124. https://doi.
org/10.1093/jnci/djx124
[4] Evans DG, Baser ME, McGaughran J, Sharif S, Howard E, Moran A. Malignant peripheral nerve sheath tumors in
neurofibromatosis 1. J Med Genet. 2002 May 1;39(5):311-4. https://doi.org/10.1136/jmg.39.5.311
[5] Watson KL, Al Sannaa GA, Kivlin CM, Ingram DR, Landers SM, Roland CL, et al. Patterns of recurrence and survival
in sporadic, neurofibromatosis type 1-associated, and radiation-associated malignant peripheral nerve sheath tumors. J Neurosurg. 2017 Jan 1;126(1):319-29. https://doi. org/10.3171/2015.12.JNS152443
[6] Kar M, Deo SS, Shukla NK, Malik A, DattaGupta S, Mohanti BK, et al. Malignant peripheral nerve sheath tumors (MPNST)- clinicopathological study and treatment outcome of twentyfour cases. World J Surg Oncol. 2006 Dec;4:1-8. https://doi. org/10.1186/1477-7819-4-55
[7] Kroep JR, Ouali M, Gelderblom H, Le Cesne A, Dekker TJ, Van Glabbeke M, et al. First-line chemotherapy for malignant peripheral nerve sheath tumor (MPNST) versus other histological soft tissue sarcoma subtypes and as a prognostic factor for MPNST: an EORTC soft tissue and bone sarcoma group study. Ann Oncol. 2011 Jan 1;22(1):207-14. https://doi. org/10.1093/annonc/mdq338
[8] Hagizawa H, Nagata S, Wakamatsu T, Imura Y, Tanaka T, Outani H, et al. Malignant peripheral nerve-sheath tumors
in an adolescent patient with mosaic localized NF1: A case report. Mol Clin Oncol. 2020 Feb 1;12(2):155-9. https://doi.
org/10.3892/mco.2019.1969
Files | ||
Issue | Vol 9 No 2 (2024): March-April | |
Section | Case Report(s) | |
DOI | https://doi.org/10.18502/crcp.v9i2.16925 | |
Keywords | ||
MPNST NF1 RT Chemotherapy Local control Distant control |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |