Peripheral nerve tumors
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Peripheral nerve tumors are a type of tumor that develops within or near the nerves that carry signals from the brain to the rest of the body. The purpose of these nerves is to regulate the muscles in the body that allows movement, such as walking, running, and doing other activities, controlling the body to blink and swallow.
Most peripheral nerve tumors are non-cancerous, however their development in the body can still cause discomfort, damage to the nerves, and loss of function.
Peripheral nerve tumors come in several forms.
- Intraneural tumors: tumors damage the nerves by growing inside them.
- Extraneural tumors: tumors that cause nerve damage by pressing against them.
Different types of peripheral nerve tumors
- Acoustic neuroma: the vestibular nerve that connects your inner ear to your brain might develop a noncancerous tumor known as a vestibular schwannoma.
- Desmoid tumors: growth of benign tumor at the connective tissue, also known as aggressive fibromatosis. Desmoid tumors are most commonly found in the abdomen, arms, and legs.
- Malignant peripheral nerve sheath tumors: this particular type of cancer affects the spinal cord by
developing in the nerve lining, also known as neurofibrosarcomas. - Neurofibroma: a type of nerve tumor manifests as soft lumps on or beneath the skin and can form within a main or minor nerve.
- Neurofibromatosis: tumors develop on nerve tissue as a result of a series of hereditary diseases called neurofibromatosis in the neurological system, including the brain, spinal cord, and nerves.
- Schwannoma: a specific kind of nerve sheath tumor. Adults are most likely to develop this kind of benign peripheral nerve tumor, however it could affect people at any age, and it can happen anywhere in your body.
Symptoms
A peripheral nerve tumor might directly affect the primary nerve, or it can press on surrounding nerves, blood vessels, or tissues, causing symptoms and signs to appear. These may become more evident as the tumor grows.
Signs and symptoms differ based on where the tumors are located, and which tissues are affected
- Lump or swelling under the skin
- Tingling sensation
- Pain or numbness
- Loss of balance
- Weakness
- Loss of function of the affected area
If you have any of the following symptoms, especially if a lump is developing quickly, visit a specialist immediately.
Causes
The majority of peripheral nerve tumors have unknown causes as it could happen from an immature gene, or by an accident or a surgery, while others, like neurofibromatosis (types 1 and 2) and schwannomatosis, are connected to well-known hereditary disorders.
Risk factors
It is more typical for persons with peripheral nerve tumors to have:
- Neurofibromatosis (types 1 and 2) and schwannomatosis: Typically, these tumors are not malignant. However, these tumors typically grow on or close to the body’s nerves. Depending on where they are, these tumors can cause different kinds of signs and symptoms.
- Radiation exposure: A history of treatment with radiation increases the likelihood of developing peripheral nerve tumors.
Diagnosis
A specialist may inquire about the signs and symptoms, go through the patient’s medical history, and conduct both a neurological exam and a general examination in order to properly diagnose the peripheral nerve tumor. To help identify the source of the signs and symptoms, specialist will request a number of tests.
- Imaging tests: used to determine the extent of the tumor. Imaging test includes:
- Magnetic Resonance Imaging (MRI) scan that creates a thorough, 3-D image of your nerves and surrounding tissue using magnetic and radio waves.
- Computerized tomography (CT) with series of images are captured. The specialist can assess how the peripheral nerve tumor may be affecting patients by creating a thorough view of it using the images on a computer.
- Electromyogram (EMG): Specialist will insert a tiny needle into the muscle for this test in order to record the electrical activity that occurs in the muscle while the patient tries to move it using an electromyography device.
- Nerve conduction study: It measures the speed at which electrical signals leave the neurons and reach your muscles. This test will be conducted along with EMG.
- Tumor biopsy: To properly obtain a cell sample for examination, a specialist may advise a needle biopsy operation, such as fine-needle aspiration or core needle biopsy. Patient might require local or general anesthesia for the biopsy, depending on the size and location of the tumor.
- Nerve biopsy: Specialist may perform a nerve biopsy if the patient has a condition like increasing peripheral neuropathy or swollen nerves that resemble nerve tumors.
Treatment
Treatment will be determined by the type of peripheral nerve tumor that affects the tissues and nerves, as well as the underlying symptoms. Treatment options for peripheral nerve tumors includes:
- Monitoring: close monitoring of the growth of the tumor if the tumor is small and slowly growing. Regular consultation will be advised together with imaging test (CT or MRI) for assessment of the size of the tumor.
- Surgery: complete surgical excision of the tumor without causing any damage to the surrounding nerves or healthy tissues. If the tumor cannot be totally removed, surgeons will remove the tumor as much as possible. Surgery may result in nerve damage depending on the
position and size of the tumor. Inaccessible tumors can now be reached by specialists using the newest technologies. It is simpler to differentiate a tumor from healthy tissue when using the powerful microscopes used in microsurgery. However, risk can be determined by the tumor’s size, location, and surgical technique. There is a possibility that some of the tumor will reoccur. - Stereotactic radiosurgery: this treatment, which delivers radiation specifically to the tumor without any incisions and may be recommended by the specialists to treat some peripheral nerve tumors in or near the brain. Radiosurgery has risks such as weakness or numbness in the area being treated. Radiation will unlikely cause a development of another cancer at the part of the body that received radiation.
- Standard cancer therapy: Surgery, chemotherapy, and radiation therapy are all common cancer treatments for malignant tumors. However, there is a possibility that the tumor will return even after treatment.
- Rehabilitation: in order for the patient to effectively regain the mobility and functioning of the damaged nerves, physical and occupational therapists will support the patient in recovering after surgery. In some instances, the arm or leg need to be in a position that promotes healing, so the specialist may use a brace or splint.
