A neuroma is a tumor that grows from Schwann cells and is benign. Depending on the location of the tumor, the symptoms can vary greatly from case to case; However, pain and nerve failures are particularly common. The primary treatment options are surgical removal of the neurinoma and radiation therapy.
What is a neuroma?
The neuroma is a specific type of tumor and grows from Schwann cells. These types of glial cells grow in a spiral around the nerve cell process, creating an electrically insulating layer that increases the speed of signal transmission. Neurinomas that develop on these Schwann cells therefore impair the functioning of the respective nerve. See percomputer for Childbed Fever Explanation.
Most of those affected are between 40 and 60 years old; in principle, however, the neuroma can develop in any age group. Because of its benign nature, it is also known as benign peripheral nerve sheath tumor (BPNST). Other names for the neurinoma are: Schwannoma, Schwann cell tumor and neurolemmoma or neurilemma.
In very rare cases (less than one percent), what is normally a benign neuroma can turn into a malignant neurofibrosarcoma. Arms and legs are particularly often affected by neurofibrosarcoma, while neurinoma occurs primarily in the head and neck.
Like all tumours, the neuroma also goes back to new growths in the affected tissue. In the case of neurofibromatosis type 2, the probability of the development of a neurinoma is significantly increased. The hereditary disease leads to the formation of tumors in the brain, with the new growths predominantly grouped around the vestibulocochlear nerve.
Furthermore, in many cases, the spinal cord and other cranial nerves have other tumors. Malformations of the eyes, skin changes and abnormalities of the central nervous system as a whole are also common in type 2 neurofibromatosis. In addition to the general symptoms of the neuroma and possibly acoustic neuroma, there are additional complaints in this disease that go back to other tumors.
Doctors distinguish between two sub-forms of neurofibromatosis type 2, with the Feiling-Gardner type only appearing from the age of 20 and characterized by slowly growing, central tumors, whereas the onset of the disease in the Wishart type is before the age of 20 and this subtype leads to many rapidly growing tumors.
Less commonly, neuromas are a side effect of neurofibromatosis type 1 ; there, however, they also occur statistically more frequently and the disease is more common overall than type 2. In addition to neurofibromas, café-au-lait spots and Lisch nodules in the iris are characteristic features of type 1 neurofibromatosis.
Symptoms, Ailments & Signs
Since the neuroma can form at different points in the nervous system, the appearance of the disease is very diverse. Symptoms often include pain ; which part of the body is affected depends on the damaged nerve tracts.
The nerve from whose Schwann cells the neuroma grows may no longer be able to function at all. In this context, paralysis can occur. Typically, the symptoms manifest only gradually and increase in size and severity because the neuroma is often slow-growing.
The acoustic neuroma is a specific form of schwannoma. It is a neuroma that grows on the vestibulocochlear nerve. The eighth cranial nerve innervates the inner ear and is important for both hearing and balance.
The acoustic neuroma manifests itself in acoustic complaints such as tinnitus and hearing problems as well as in balance disorders and dizziness. Other possible symptoms include nausea, vomiting, facial numbness, facial paralysis, decreased sensitivity to pressure and touch in the external ear canal, double vision, earaches, and headaches.
Diagnosis & course of disease
Based on the clinical picture, neurologists can often already roughly narrow down where the cause of the nervous disorder that leads to the individual symptoms lies. An examination using magnetic resonance imaging (MRI) or other imaging methods makes the tumor visible and can also show other causes and factors. Very small neoplasms that do not yet cause any restrictions are not always recognizable due to the limited resolution of the imaging.
Although neurinoma is a benign and slow-growing tumor, in the long term it can cause complications that require surgical removal of the tumor. If the tumor is still small, there are usually no symptoms. However, larger neurinomas often displace neighboring nerves, which leads to the corresponding health problems.
If the neurinoma is located in the lumbar spine, chronic back pain that radiates into the legs occurs due to compression of adjacent nerves. As the tumor continues to grow, the muscle supplied by the corresponding nerve may become weak. If the neurinoma is in the cervical spine, long-term chronic pain and sensory disturbances in this area will radiate into the arms.
A neuroma in the spinal canal can even lead to paraplegia. There is not much space in the spinal canal, so that in extreme cases the displacement of the neighboring nerves can cause them to lose their function. If there is a neurinoma in the finger or hand, compression of nearby nerves can cause tingling and numbness there.
When the auditory nerves are affected, hearing loss sometimes progresses to deafness, dizziness and tinnitus. A dangerous complication is the increase in intracranial pressure to the point of stagnation of the liquor due to the constriction of the brainstem. In very rare cases, the tumor can also become malignant.
When should you go to the doctor?
A doctor should be consulted as soon as the first diffuse irregularities of the organism appear. Since the neurinoma is a tumor, caution should always be exercised. Even benign tumors must be clarified as quickly as possible so that malignant diseases can be ruled out. Swelling, pain or the development of ulcers on the body should be presented to a doctor. If there are restricted movements, general mobility disorders and unsteady gait, a doctor is required.
Loss of functionality of the sensory organs, nausea, vomiting, sensory disturbances or numbness of the skin must be examined and treated. If the person suffers from changes in vision or hearing, there is cause for concern. Double vision, reduced hearing, ear pain, a feeling of pressure in the head, or a headache are warning signals from the body that should be followed. Consultation with a doctor is necessary as soon as facial paralysis, imbalance and hypersensitivity to touch stimuli occur.
A neuroma is characterized by a slow increase in the existing symptoms. This leads to a gradual malaise, a decrease in performance and a general feeling of illness. If the condition of the person concerned does not improve, he should discuss the observations with a doctor so that the cause can be clarified.
Treatment & Therapy
Immediate intervention is not necessary in every case. Neurinomas typically develop slowly, sometimes allowing the clinician to observe the behavior of the tumor before deciding on the type of therapy. The potential treatment risks also play a role in this consideration.
As with all therapeutic approaches, the individual consideration of costs and benefits for the respective patient is decisive; a blanket judgment is not possible. Doctors can surgically remove the neuroma to prevent the tumor from growing further and preventing the symptoms from spreading.
However, the neuroma grows from the Schwann cells, which electrically insulate the affected nerve cell. Therefore, the surgeon may also have to remove part of the nerve with the tumor, which can lead to the persistence of the symptoms that have already occurred.
After removal, a thorough histological examination provides further insight into the nature of the tumor. Radiation therapy is another option for treating the neurinoma, in which ionized radiation is applied to the affected tissue. Radiation dose and duration of treatment vary by patient.
Outlook & Forecast
Since neurinomas are usually benign, the prognosis is generally very good. Most tumors can be easily surgically removed. This also applies to advanced or larger neurinomas. In a few cases, there are complications that can lead to consequential damage. However, some of these restrictions are short-lived. Hearing disorders are the most common. Disorders of the vestibular nerve also occur extremely rarely.
A few weeks after the procedure, most people are usually fully recovered. Once the neuroma has been completely removed during surgery, it usually does not recur. The life expectancy of those affected is normal. Rarely, parts of the tumor cannot be surgically removed. In these cases, it is possible for a recurrence to occur. Treatment of such a tumor capsule by radiation is often successful. In about 1% of patients, the neurinoma develops into a malignant neurofibrosarcoma.
Without treatment, the prognosis is much worse. The neuroma often continues to grow and increases intracranial pressure, which can be quite dangerous for those affected. The earlier the tumor is treated, the better the prospects for treatment.
Neurinomas often develop in connection with neurofibromatosis types 1 and 2. Since both forms are genetic diseases, those affected can take this into account when planning a family.
Aftercare for a neurinoma is closely coordinated with the attending physicians, but often also with physiotherapists, speech therapists, ergotherapists or sports therapists. It is important to see the radiologist at regular intervals, who can take pictures to check whether a recurrence may have occurred.
Damage has often been caused by the tumor, which continues to cause symptoms after it has been removed. Sensory disturbances in limbs or speech disorders, for example, are treated by the relevant therapists. These often provide the patients with exercises that they can continue to practice on their own at home as part of the aftercare.
Psychological support is also often very important for those affected during aftercare. Knowing about the tumor and the fear of a possible recurrence can often be dealt with much better by talking to friends and family and by being distracted by social contacts. In this context, self-help groups are often a particularly helpful building block in individual aftercare for neuromas.
People who suffer from the same or a similar illness bring a special understanding to the exchange of experiences and have a whole range of practical tips ready for those seeking advice and help. The mental state can also be stabilized by relaxation methods such as autogenic training or progressive muscle relaxation and by attending yoga courses.
You can do that yourself
A malignant neuroma must always be treated by a doctor. The growth must be removed by surgery or radiation or chemotherapy to avoid degeneration and other complications. In the case of a benign neuroma, therapy can be supported by a number of self-help measures and home remedies.
General measures such as a change in diet and moderate exercise have proven effective. Avoiding salt and gluten can have a positive effect on the growth of the growth. Caffeine, alcohol and sugar should also be avoided, as these substances put an additional strain on the body.
After a surgical procedure rest and protection are important. The patient should not expose himself to unnecessary stress and must care for the surgical wound according to the doctor’s instructions. If inflammation or bleeding occurs, the doctor must be informed. Finally, it is important to go regularly for cancer screening. If there is a suspicion of a recurrence, the patient must call in the doctor and have the unusual symptoms clarified. A neuroma must be clarified by a doctor in any case, because self-treatment of the causes is not possible.