A CLINICAL ANALYSIS OF MALIGNANT SCHWANNOMA

In this study, we reviewed the clinical features of 11 patients with m alignant schwannoma who were treated in our institute. Five patients h ad coexistent von Recklinghausen's disease and one of them showed mult ifocal occurrence. Patients with the centrally located tumors had a po orer prognosis than those with the others. The overall 3-year survival rate was 36%; 40% in patients with von Recklinghausen's disease and 3 3% in the others. At the time of the last follow-up, 9 patients had di ed of the tumor, one continued to be tumor free, and one was alive wit h tumor. Postoperative local recurrence developed in 5 patients (45%); 4 out of 6 patients (67%) who underwent a marginal excision and one o ut of 3 (33%) who underwent primary amputation. There was no local rec urrence in patients after a wide excision with at least 3 cm of normal tissue removed surrounding the tumor in all directions. Nine patients (82%) developed pulmonary metastasis. The effect of adjuvant chemothe rapy was not clear in this study. The high risk of pulmonary metastasi s in this disease indicates the necessity of more effective adjuvant c hemotherapy.