Treatment of Tumors in the Peripheral Nervous System – Schwannomas and Neurofibromas

Much like in every other cell or tissue in our bodies, the cells of our nervous system can develop tumors as well, among them are tumors of the peripheral nervous system. Two of the most common of these types of tumors, Schwannomas and Neurofibromas, are usually benign. Nevertheless, these tumors can cause severe localized pain and in certain cases can even disrupt normal sensation or cause weakness, due to disruption to the function of the nerve fibers themselves – a condition that requires their removal in a delicate operation performed by an expert and experienced neurosurgeon. Professor Shimon Rochkind, a senior neurosurgeon at the Neurosurgical Center for Excellence at the Herzliya Medical Center, is considered to be a world-renowned surgeon with extensive experience performing these operations.

Schwannomas: Features and Symptoms

Schwannomas are tumors that develop in peripheral nerves, which are the nerves that are located outside the central nervous system, which is composed of the brain and the spinal cord. Schwannomas are named for the cells from which they are derived – the Schwann cells – which envelope the nerve fibers.

Schwannomas are typically benign tumors, though this does not prevent them from causing extensive symptoms, particularly when they are very advanced. Chronic pain is the primary manifestation, and sometimes even disturbances to sensation or development of weakness, as well as a feeling of discomfort in and around the area where the tumor develops. Schwannomas are usually slow growing and therefore they are often only discovered when they reach a relatively large size and begin to cause serious pain.

Schwannomas can develop in the arms and the legs or in the brachial plexus, a set of nerves located within the shoulder region, as well as in the nerves located in the lower spine that branch off of the spinal cord.

Neurofibromas: Characteristics and Symptoms

Neurofibromas (NFs) are also benign tumors. These tumors develop from the connective tissue that makes up the nerve sheath. Neurofibromas are often found in patients with a particular genetic disorder known as Neurofibromatosis Type 1 (NF-1), but they can also develop in individuals who do not have this condition.

Neurofibromas often develop right under the skin, in which case they can be felt as a mass or a lump. However, sometimes they can grow on internal organs – around the spinal cord and on organs inside the abdomen. These tumors can also press on nerve fibers, and this pressure can result in pain, discomfort and sometimes also disturbances of sensation in the area where they develop.

The Approach to Diagnosis and Treatment

Due to their similar nature, Schwannomas and Neurofibromas are diagnosed and treated in a similar manner. Diagnosis is usually made using an MRI scan or other advanced imaging techniques, depending on the patient’s specific symptoms and based on the findings previous examinations.

The only treatment in these instances is the microsurgical removal of the tumor. These operations require extensive skill, as it is crucial that the nerve tissue upon which the tumors have developed be preserved in order to ensure their integrity as much as possible while the tumor is removed. The operation thus achieves two important objectives – removal of the tumor in its entirety on the one hand and preservation of the normal function of the nerves in the area of the tumor on the other.

Prof. Rochkind, a specialist in the treatment of conditions involving the peripheral nerves, has performed a long line of such operations. In close collaboration with an oncological orthopedic surgeon, he has demonstrated impressive results that allow the patient to return to normal function in most cases.

During the operation, the nerve fibers that are not part in the tumor are careful separated, maintaining their normal structure. The tumor is then removed in its entirety. The operation includes the use of the most advanced surgical instruments, which are available to the surgical team at the Neurosurgical Center for Excellence at the Herzliya Medical Center, including a surgical microscope that enables the handling of delicate and microscopic nerve fibers. The operation lasts up to two hours, depending on the nature of the tumor, as well as its location and the degree of involvement of nerve tissue with the tumor.

Are you suffering from localized pain and tenderness?

Have you found a mass that seems to be growing slowly?

Does touching the mass impair sensation or cause you to feel an electric current sensation?

Contact us today to receive comprehensive and professional healthcare services at the Neurosurgical Center for Excellence at the Herzliya Medical Center.

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