Benign peripheral nerve sheath tumors
A human body is made up of peripheral nerves that connect the spinal cord and the brain to the rest of the body. The major role of these nerves involves controlling the muscles to ensure normal body functions. Some of these functions include walking, swallowing, and blinking, among other significant activities.
Like any other body organ and nerves, the peripheral nerves are also prone to a range of disorders and malfunctions.Benign peripheral nerve sheath tumors are one of the diseases that develop and affect the peripheral nerve. Whereas most of these tumors are non-cancerous, they can result in severe nerve damage and muscle control loss.
Types of Benign Peripheral Nerve Sheath Tumors
Some of the commontypes of peripheral nerve sheath tumors include;
- Schwannoma
Schwannoma is the most common type of benign peripheral nerve sheath tumor. It mainly affects adults at any age and can develop in any part of the body. Normally, schwannoma originates from the fascicle in the major nerve and interferes with the entire nerve system.
In general, as the schwannoma continues to enlarge, it affects more bundles, making it harder to remove. However, these tumors tend to grow gradually.
Other types of schwannoma tend to enlarge and take an irregular shape of the dumbbell tumors, especially in the pelvis or the spine. In case the schwannoma develops in the leg or the arm, it may be associated with a lump or mass.
- Neurofibroma
Neurofibroma is another common kind of benign peripheral nerve sheath tumor. It mainly develops in the middle of the nerve. However, a neurofibroma can also occur from various nerve bundles and result in a few minor symptoms.
In addition, neurofibroma mostly affects individuals with neurofibromatosis 1. This is a genetic condition that triggers the tumors to develop on the nerves.
- Lipoma
A lipoma is mainly caused by the slow-growing fat cells. It’s usually associated with soft lumps or masses that appear beneath the skin on the back, neck, arms, or shoulders. When a lipoma develops near the nerve, it tends to compress it. However, this doesn’t trigger any pain or associated issues. But to manage the condition, the doctor will monitor the nerve during the routine checkups.
- Perineurioma
Although rare, perineurioma is a benign peripheral nerve sheath tumor that can occur as an extraneural tumor. This condition is more common among children and teenagers. Over time, perineurioma can slowly result in progressive weakness loss of senses around the leg and arm.
- Ganglion cyst
Ganglion cysts can sometimes arise due to an injury; however, most of these cysts have unknown causes. They mainly occur around the joints in the wrist and can sometimes result in pain, affecting daily activities. Although some ganglion cysts disappear with time, even without treatment, others require an operation to remove. This is if they cause compression on the surrounding nerves.
Causes of Benign Peripheral Nerve Sheath Tumors
Basically, there are not actual causes or triggers of benign peripheral nerve sheath tumors. However, some types of peripheral nerve sheath tumors are genetic, hence can be passed from the parent to the child.
Schwannoma, the most prevalent kind, usually begins from a single bundle within the major nerve. With time, it tends to displace the entire nerve. On the other hand, neurofibroma, another prevalent type, develops in the nerve and can sometimes occur from various nerve bundles.
Perineuriomas, one of the rarest types, often grow and develop in or on the nerve. The tumors that develop on a nerve can trigger complications, especially if they compress the nerve. Some other benign tumors that occur on the nerves are characterized by soft lumps of gradually-growing fat cells. Examples of these benign tumors include ganglion cysts and lipomas.
Signs and Symptoms of Benign Peripheral Nerve Sheath Tumors
Not every person with a benign peripheral nerve sheath tumor will experience signs and symptoms. However, as the condition continues to advance, you may experience peripheralnerve sheath tumor symptoms like;
- Tingling, numbness, burning, or itching sensation
- Extreme weakness in the muscle
- Pain
- Unusual mass or lump that can be felt or seen
Diagnosing Benign Peripheral Nerve Sheath Tumors
If the doctor suspects a benign peripheral nerve sheath tumor, they can recommend several tests and procedures. This helps determine the type of cancer and the exact location.
Some of the diagnostic tests and procedures of benign peripheral nerve sheath tumors include;
- Magnetic resonance imaging (MRI) test
MRI is the most common diagnostic test that doctors often use to pinpoint benign peripheral nerve sheath tumors. It’s an effective technique that uses radio waves and powerful magnetic fields. This is to create detailed 3-dimensional images of the nerves and the nearby tissues. Generally, this makes it easier for the doctor to identify if there is a tumor. It also helps determine if the cancer is in or on the nerve.
- Electromyogram (EMG)
When performing this test, the doctor inserts a small thin needle into the muscles. An electromyography tool will then take a record of the electric activity within the muscles while trying to move.
- Computerized tomography (CT) scan
The doctor can use a CT scanner that moves around the body while recording a variety of images. This makes it easy to check the presence of tumors and the specific location. However, this method is not effective as the MRI test for diagnosing benign peripheral nerve sheath tumors.
- Tumor biopsy
In case the doctor discovers a nerve tumor while performing the imaging tests, they can recommend a biopsy. Nerve sheath tumor biopsy involves the removal of a small sample of peripheral nerve cells for further tests and analysis. Based on the location and the size of the tumor, doctors can perform tumor biopsy under local or general anesthesia.
- Nerve biopsy
Doctors can recommend nerve biopsy, especially if the type of peripheral nerve tumor is progressive or advancing. Alternatively, it can be if the condition is associated with large nerves that replicate the nerve tumors.
- Nerve conduction study
In most cases, the doctor can perform a nerve conduction study alongside an EMG test. It’s typically a procedure to measure the speed or how fast the nerves transport electric signals towards the muscles.
Benign Peripheral Nerve Sheath Tumors Treatment and Recovery
Basically, benign peripheral nerve sheath tumors are a rare type of disease. As such, it’s essential to seek a medical expert who regularly addresses such health conditions. Alternatively, you can consult a physician who is more familiar with peripheral nerve tumors. It can also include the possible risks and pros of the treatment alternatives.
Benignperipheral nerve sheath tumors treatment mainly includes a surgical procedure to extract the tumors or an observation. However, most peripheral nerve sheaths tumors are less severe or aggressive and do not require any treatment.
At times, there are limited chances or risks that the tumor can become malignant over time and doesn’t cause any health issues. In such a case, surgery might not be necessary. Instead, the doctor can recommend observation, including follow-up through serial imaging and repeated physical examination.
The doctor can also suggest regular observation when the tumor is located in a sensitive area that makes it hard to extract. With observation, the doctor will assess cancer and check if it is progressing or gradually advancing.
For severe tumors with progressive signs, a surgical operation is necessary to extract them. A procedure to treat schwannomas involves peeling off the nerve surface with a microsurgical tool. However, the entire nerve is left intact.
When it comes to treating neurofibroma, it will involve opening up the nerve to remove the tumor. This is mainly because, in neurofibroma, the tumor is usually located inside the nerve.
The recovery process following a nerve sheath surgery usually varies from one patient to another. It can depend on the tumor's exact location, the types, and the degree of the surgical procedure.
Once the surgery is complete, the doctor will give you helpful instructions regarding the operation and recovery. In case the tumor shows signs of malignancy, the doctor can recommend an oncologist. He or she will help analyze the condition and develop a proper treatment plan. The plan can include treatment options such as radiation therapy and chemotherapy.
What to Consider Before Removing Benign Peripheral Nerve Sheath Tumors
Generally, benign peripheral nerve sheath tumors develop gradually and can be characterized by a lump in the body. At times, they can affect normal daily activities and functions. They can also cause discomfort, numbness or tingling, chronic pain, and weakness.
Therefore, when the tumors cause such problems, it may be necessary to consider removing them. Surgery to remove peripheral nerve tumors is usually done without damaging or interfering with the nerve system. In most cases, it involves resection of the tumor outside the nerve without altering the functions.
Conclusion
Benign peripheral nerve sheath tumors are non-cancerous diseases that develop and affect the peripheral sheath nerves. Although they are usually considered less aggressive, they can sometimes result in certain complications, including nerve damage and impacts of various body functions.
While finding a specialized medical professional is essential for addressing such tumors, you can always consider the CloudHospital. It works with several skilled and experienced medical experts who can diagnose, treat, and manage various benign peripheral nerve sheath tumors.