Schwannoma tumors are slow-growing tumors that grow from inside the nerve sheath. Unlike other neural tumors that arise from the nerve sheath, schwannomas form from schwann cells of the individual nerve fibers. While most schwannomas occur randomly, specific conditions such as von Recklinghausen's disease, sometimes called neurofibromatosis (NF), can cause schwannomas to grow throughout the body. Physical examination combined with body scanning can help doctors determine if NF is present. Treatment for schwannoma tumors varies depending on the size and location of the tumor, symptoms the tumor is causing and the health of the patient.
Schwannomas are predominantly benign tumors. In rare cases, the tumors can become malignant. The tumors can grow anywhere throughout the nervous system. The most common places for schwannoma tumors are in the brain, throughout the trunk, and at the flexes of the peripheral nerves. Treatments are dependent on the location and whether the tumor is benign or malignant.
Surgical intervention is the most common treatment for schwannomas. Because schwannomas are nerve, or neural, tumors, a neurosurgeon performs these surgeries. It is important to have a skilled neurosurgeon in order to have the best possible outcome. When dealing with schwannomas, nerve fibers are involved, which can mean lifelong problems if they are damaged or cut. Neurosurgeons also have sub-specialties or focus areas that they regularly treat. Finding a neurosurgeon with an area of focus matching the location of the tumor further reduces nerve damage risks. Neurosurgeon-oncologists deal with malignant neural tumors, so patients with malignant schwannomas benefit greatly from treatment from this specialty. Post-surgery, patients often have nerve dysfunction such as numbness, tingling, and pins and needles sensations. Sometimes surgery causes nerve trauma, which leads to temporary nerve pain and sensitivity. If sacrifice of an individual fiber occurs, numbness can be permanent.
Gamma Knife Surgery
If a schwannoma is particularly large, the neurosurgeon may choose to use Gamma Knife or reflected solar radiation (FSR) to shrink the tumor. This can be a primary treatment or can shrink the tumor prior to surgery. Smaller tumors are easier to remove and lower the risk of significant nerve damage.
Close supervision by a doctor is sometimes the best choice. If the tumor is not causing any symptoms, has no signs of malignancy and the patient and doctor are comfortable with leaving it in for the time being, the tumor is carefully monitored periodically to ensure that it is not a danger to the patient. Most often, the patient has regular checkups including magnetic resonance imaging (MRI) scans to measure growth and tumor features. The doctor looks over these scans, and combined with any new symptoms determines whether surgical intervention is necessary.
People with benign schwannomas that are in poor general health may not be candidates for surgery. In these cases, radiation may shrink the tumor and reduce the symptoms associated with it. Doctors use close supervision of the tumor to make sure it doesn't undergo any malignant transformation.