Therapy of malignant schwannomas: usefulness of an integrated radiologic. Surgical therapy.

A series of 30 patients with malignant schwannomas, who underwent diagnostic and therapeutic treatment at the Istituto Nazionale Tumori of Milan, is presented. Twenty-five of the patients have been followed for at least 3 years. Paravertebral regions were the most frequent sites of primary localizations of the malignant schwannomas. Computerized tomography, echography, nuclear magnetic resonance and arteriography are very important for a radio-diagnostic study. Arteriography is very useful for the diagnosis of malignancy and recurrence of such tumors. Three years after an integrated radiologic-surgical treatment, 14 of 25 patients (56%) were free of disease. Such a percentage is higher than other series of patients who prevalently underwent only surgery. Two patients who did not undergo grossly radical surgery were free of disease 3 years after radiotherapy. The dose of ionizing radiation sufficient for a good possibility of cure is about 52 Gy or higher.