Nerve sheath tumors of the sciatic nerve and sacral plexus.

Eight patients with sciatic nerve and sacral plexus nerve sheath tumors, seen at Louisiana State University Medical Center in Shreveport, are presented. These cases illustrate the broad spectrum of pathology and modes of presentation of patients with nerve sheath tumors in this region. Patients can be divided into 4 groups. Group I includes subgluteal and/or thigh lesions with a well-defined mass on CT. Group II patients have neuroforaminal enlargement (defined by CT) and usually have radicular leg pain. Patients in group III have intrapelvic tumors with extension into the thigh. They usually have a poorly defined mass on CT. Group IV includes patients that have an intrapelvic mass (usually well defined) with radicular leg pain and/or mass effect. CT scanning proved to be the diagnostic procedure of choice. It delineated the location and extent of the tumor and thus was important in determining resectability. The variable course of these tumors is emphasized. A conservative nonoperative approach should be considered in asymptomatic and/or neurologically stable patients.