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Clinical Research
Uncorrected Proof. Available online 6 August 2026

Malignant triton tumour of the nerve roots: Challenging the neuropreservation paradigm. Presentation of two cases and review

Malignant triton tumour of the nerve roots; challenging the neuropreservation paradigm. Presentation of two cases and review
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Alicia Godoy Hurtadoa,
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aliciagodoyhurtado@gmail.com

Corresponding author.
, Patrick Bärtschib, Adela Sabio Gonzalezc, Osamah E.L. Rubaidia
a Department of Neurosurgery, Hospital Universitario de Jaén, Spain
b Department of Neurosurgery, Hospital Vithas de Alicante, Spain
c Department of Pathology, Hospital Universitario de Jaén, Spain
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Abstract

Malignant triton tumour constitutes a rare and particularly aggressive subgroup within the so-called malignant peripheral nerve sheath tumours.

It belongs to the group of sarcomas and is diagnosed more frequently and aggressively in patients with neurofibromatosis type I, with a peak age of around 30 years.

They develop preferentially in medium and large nerves such as cranial nerves, plexuses and nerve roots.

The 5-year survival rate is approximately 5–15% according to published series, compared to 34–52% in other malignant tumours of the nerve sheaths.

Radical surgery with clear margins followed by radiotherapy for local control appears to offer the best results in terms of survival.

We describe two cases treated at our centre and review the scientific literature, highlighting the role of the pathologist and neurosurgeon in their management.

Keywords:
Triton tumour
Malignant nerve sheath tumours
Peripheral nerve
Rhabdomyosarcoma
Resumen

El tumor triton maligno constituye un raro subgrupo especialmente agresivo dentro de los llamados tumores malignos de la vaina de los nervios periféricos. Pertenece al grupo de los sarcomas y se diagnostican con más frecuencia y agresividad en pacientes afectos de neurofibromatosis I, con un pico de edad en torno a los 30 años.

Se desarrollan preferiblemente en nervios de mediano y gran tamaño como los pares craneales, plexo y raíces nerviosas. La tasa de supervivencia a los 5 años es de aproximadamente 5-15% según las series publicadas frente a un 34-52% en el resto de tumores malignos de las vainas de los nervios. La cirugía radical, con márgenes libres seguida de radioterapia para el control local, parece ofrecer los mejores resultados en términos de supervivencia. Describimos dos casos tratados en nuestro centro y revisamos la literatura científica destacando el papel del patólogo y el neurocirujano en su manejo.

Palabras clave:
Tumor triton
Tumor maligno de vainas nerviosas
Nervio periferico
Rabdomiosarcoma

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