WOFAPS 2025 8th World Congress of Pediatric Surgery

Yousef abdalazeem ¹, Mahmoud Farag ², mohamed elsafti ², Maged Elsafti ³, Zahid Hassan ²

¹ Salford Royal Foundation
² Department of Paediatric Surgery Alder Hey Children's Hospital NHS Foundation Trust Liverpool, United Kingdom
³ University of Oxford, Oxford, UK

Purpose: Schwannomas of the brachial plexus are exceedingly rare in pediatric patients and often present diagnostic challenges due to subtle clinical manifestations and low incidence. This systematic review synthesizes available pediatric case reports to elucidate clinical presentation, diagnosis, management, and outcomes.

Method: Conducted according to PRISMA guidelines, a systematic literature search was performed using PubMed, Scopus, and Web of Science databases with the keywords "brachial plexus schwannoma" and "pediatric" or "child". Inclusion criteria were English-language case reports of histopathologically confirmed brachial plexus schwannomas in patients aged ≤18 years. Four case reports met these criteria.

Results: Patients ranged from 10 to 16 years, showing slight female predominance. Clinical presentations included monoparesis, upper limb weakness, radiating neuropathic pain, and palpable masses. MRI consistently revealed encapsulated, hyperintense lesions on T2-weighted sequences. Histopathology confirmed schwannomas with positive S100 immunostaining in all cases. Surgical excision was performed in all patients without malignant transformation. Outcomes were favorable, with resolution or improvement of neurological symptoms and no recurrence during follow-up (6 months to 2 years).

Conclusion: Pediatric brachial plexus schwannomas, though rare, exhibit consistent radiologic and histopathologic characteristics. Early MRI diagnosis and timely surgical intervention result in excellent outcomes. Increased clinical awareness of this condition in pediatric patients presenting with unexplained upper limb symptoms may facilitate earlier diagnosis and improved functional recovery.