The Desmoid Tumor Research Foundation

September 2019

Using intraoperative neurophysiological monitoring in the surgical treatment of desmoid-type fibromatosis involving brachial plexus: a case report and literature review

Author Information

Ji Yon Kim(1), Hyo Jae Kim(1), Mina Jung(1), Se Keun Oh(1), Seung Ho Choi(2), Yong Seo Koo(1).

(1)Dept of Neurology, Asan Medical Center, Univ of Ulsan College of Medicine, Seoul, Korea. (2)Dept of Otolaryngology, Asan Medical Center, Univ of Ulsan College of Medicine, Seoul, Korea.

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Summary

This study presents a case of surgical resection of desmoid type fibromatosis (DF) at brachial plexus, which utilized intraoperative neurophysiological monitoring (INM). During the operation, it was inevitable to sacrifice a superior trunk of brachial plexus due to the tumor infiltration, which was identified by triggered electromyography (EMG) monitoring. The neural injury caused the decrement of motor evoked potential (MEP) amplitude in the right deltoid, biceps, and extensor digitorum communis (EDC) muscles. The postoperative neurological exam, EMG, and nerve conduction studies suggested pan-plexopathy mainly involving superior trunk of brachial plexus. This case demonstrates the usefulness of INM in brachial plexus surgeries.

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