Brachial Plexus Tumors; Pathological Types and Surgical Approaches: Multi Center Experience

Brachial plexus tumors, are rare, present significant challenges due to their intricate anatomical location and potential impact on upper limb function. These tumors arise from nerve sheath cells, including either benign schwannomas and neurofibromas, or as malignant peripheral nerve sheath tumors (MPNSTs), which require early diagnosis and intervention to improve patient outcomes (1). Surgical resection remains the primary treatment modality, aiming to alleviate symptoms and prevent further neurological compromise.

Study Overview

• Status: Not yet recruiting
• Conditions: Brachial Plexus Tumors
• Intervention / Treatment: Procedure: brachial plexus tumors excision

Detailed Description

Brachial plexus tumors, are rare, present significant challenges due to their intricate anatomical location and potential impact on upper limb function. These tumors arise from nerve sheath cells, including either benign schwannomas and neurofibromas, or as malignant peripheral nerve sheath tumors (MPNSTs), which require early diagnosis and intervention to improve patient outcomes (1). Surgical resection remains the primary treatment modality, aiming to alleviate symptoms and prevent further neurological compromise.

The choice of surgical approach is influenced by the tumor's size, location, and relationship with surrounding neurovascular structures. Anterior approaches, including supraclavicular and infraclavicular incisions, provide excellent exposure for lesions in the upper and middle parts of the plexus, whereas posterior approaches are preferred for deep-seated or retroclavicular tumors (2). Intraoperative neurophysiological monitoring (IONM) has significantly improved surgical precision, reducing the risk of postoperative deficit .

Advancements in microsurgical techniques, such as nerve grafting and nerve transfers, have improved functional recovery in patients undergoing brachial plexus tumor resection. Early intervention and meticulous dissection help preserve nerve function and minimize postoperative deficits (3). Minimally invasive techniques, including endoscopic and robotic-assisted approaches, are being explored to reduce morbidity and improve surgical precision (4).

Despite progress in surgical management, challenges remain, particularly in cases of malignant tumors where complete resection may not be feasible. Adjuvant therapies, including radiation and chemotherapy, are increasingly utilized for malignant brachial plexus tumors to enhance local control and reduce recurrence rates (5). Long-term follow-up and rehabilitation play a crucial role in optimizing functional recovery, emphasizing the need for a multidisciplinary approach (6).

This review aims to analyze the indications, techniques, and outcomes of different surgical approaches for brachial plexus tumors, providing insights into optimizing patient outcomes while minimizing surgical morbidity.

• Study Type: Interventional
• Enrollment (Estimated): 15
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Fadwa Ah ahmed, master; Phone Number: 0201002673946; Email: fadwa.ahmed5@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

.Patients diagnosed with brachial plexus tumors confirmed through imaging

.Age of Patients: Any age .

.patients who are fit for surgery .

Exclusion Criteria:

. Patients with non-tumorous brachial plexus pathologies (e.g., trauma, inflammation).

.Patients with incomplete medical records or lost follow-up data.

.Patients with recurrent tumors previously treated.

.Patients who are unfit for surgery.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: brachial plexus tumors patients; patients who has brachial plexus tumors	Procedure: brachial plexus tumors excision; excision of brachial plexus tumors

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
1-motor power and sensory improvment	Clinical: Better outcome according to MRC Muscle Power Scale and Numeric Sensory Scale (NSS) The Medical Research Council (MRC) Muscle Power Scale is commonly used to assess motor power in patients. It ranges from 0 to 5, evaluating voluntary muscle contraction against gravity and resistance. The Numeric Sensory Scale (NSS) is a simple and effective tool used to assess sensory function. It is based on a numerical rating system from 0 to 10, where patients self-report their level of sensation. This scale is commonly used in neurological examinations to evaluate sensory deficits.	2 years
Radiological out come	Radiological : Postoperative MRI to detect the residual or recurrence of lesions	2 years

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Study Director: Mohamed Ab khallaf, MD, Assiut University

Study record dates

Study Major Dates

• Study Start (Estimated): May 30, 2025
• Primary Completion (Estimated): May 1, 2027
• Study Completion (Estimated): June 1, 2027

Study Registration Dates

• First Submitted: May 21, 2025
• First Submitted That Met QC Criteria: June 3, 2025
• First Posted (Estimated): June 5, 2025

Study Record Updates

• Last Update Posted (Estimated): June 5, 2025
• Last Update Submitted That Met QC Criteria: June 3, 2025
• Last Verified: May 1, 2025

More Information

Terms related to this study

• Other Study ID Numbers: Brachial plexus Tumors

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No