Multifocal nerve lesions and LZTR1 germline mutations in segmental schwannomatosis.

Farschtschi, Said; Mautner, Victor-Felix; Pham, Mirko; Nguyen, Rosa; Kehrer-Sawatzki, Hildegard; Hutter, Sonja; Friedrich, Reinhard E; Schulz, Alexander et al. · Ann Neurol · 2016

case_series · Level IV

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Abstract

Schwannomatosis is a genetic disorder characterized by the occurrence of multiple peripheral schwannomas. Segmental schwannomatosis is diagnosed when schwannomas are restricted to 1 extremity and is thought to be caused by genetic mosaicism. We studied 5 patients with segmental schwannomatosis through microstructural magnetic resonance neurography and mutation analysis of NF2, SMARCB1, and LZTR1. In 4 of 5 patients, subtle fascicular nerve lesions were detected in clinically unaffected extremities. Two patients exhibited LZTR1 germline mutations. This appears contrary to a simple concept of genetic mosaicism and suggests more complex and heterogeneous mechanisms underlying the phenotype of segmental schwannomatosis than previously thought. Ann Neurol 2016;80:625-628.

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