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Peripheral nerve tumours are tumours that develop within or near the nerves that carry signals from the brain to the rest of the body. These tumours exert pressure on the nerves and adjacent structures, leading to neurological and brain mass symptoms. Even though rare, it can significantly affect the patient’s well-being. Malignant peripheral nerve tumours (MPNSTs), a specific type of peripheral nerve tumour, account for 5–10% of all soft-tissue sarcomas.1 This blog post provides brief insights into symptoms, causes, and treatment for peripheral nerve tumours.
Synopsis
What Are Peripheral Nerve Tumours?
Peripheral nerves are responsible for controlling muscles that help individuals to walk, swallow, blink, pick up things, and perform other activities. The peripheral nerve tumours are growths that form in the peripheral nervous system. These tumours can occur anywhere in the body, and most of them are benign.
Types of Peripheral Nerve Tumours
There are several types of peripheral tumours
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Benign peripheral nerve tumours
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Acoustic neuroma
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Desmoid tumours
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Schwannoma
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Neurofibroma
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Malignant peripheral nerve sheath tumours
Symptoms of Peripheral Nerve Tumours
The symptoms of peripheral nerve tumours develop either from the direct effects of the tumour on the main nerve or the pressure of the tumour on the nearby nerves, tissues, or blood vessels causing nerve inflammation. As the size of the tumour increases, the symptoms may also worsen.
Depending on where the tumours are located and the tissues affected, some of the symptoms include:
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Pain is a common symptom that manifests during rest or when pressure is applied to the area, leading to nerve inflammation symptoms
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Tingling or numbness
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Swelling or a lump under the skin
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Dizziness or loss of balance
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Weakness or loss of function in the affected area
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Nerve damage
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Fatigue
The peripheral nerve tumours tend to grow very slowly. The tumour located close to the brain can induce brain mass symptoms.
Causes for Developing Peripheral Nerve Tumours
The cause of developing peripheral nerve tumours remains elusive. The development of some tumours is linked to inherited conditions like neurofibromatosis and schwannomatosis, or changes caused by a gene. Individuals with a history of radiation treatment are more likely to develop peripheral nerve tumours years later.
Diagnosis for Peripheral Nerve Tumours
Your healthcare provider will ask about your symptoms and medical history to aid in the diagnosis of peripheral nerve tumours. They may also advise a general physical or neurological exam. Some of the tests that can help with the diagnosis of peripheral nerve tumours are:
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Magnetic resonance imaging: Magnetic and radio waves are used to produce a three-dimensional view of the nerves and tissues
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Computerised tomography: A CT scan is used to generate a series of images to make a detailed view of a peripheral nerve tumour
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Electromyogram (EMG): Small needles are placed into the muscles, and the electrical activity is recorded as the muscle moves
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Nerve conduction study: The test measures how fast the nerve carries electrical signals to the muscles. It is often performed with an EMG.
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Tumour biopsy: If a tumour forms on the nerve, a small sample of the tumour cells is removed for analysis, and if the tumour is cancerous
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Nerve biopsy: A biopsy of the nerve is needed for individuals suffering from progressive peripheral neuropathy or enlarged nerves that mimic nerve tumours
How Are Peripheral Nerve Tumours Treated?
Peripheral nerve problem solutions depend on the type, nerves or tissues affected, and the symptoms.
Monitoring
If the tumours are located in a difficult-to-treat area, watching and waiting may be an option to see if the tumour grows. Small and slow-growing tumours with few to no symptoms are also monitored regularly. Individuals may have to undergo CT or MRI scans every 6 to 12 months. If the tumour appears to be stable, the monitoring can extend for years.
Surgery
Treatment for peripheral nerve tumours involves surgically removing the tumours. The goal of surgery is to remove as much of a tumour without damaging the adjacent nerves and tissues. If complete removal is not possible, the surgeons remove as much of the tumour as they can. Malignant peripheral nerve tumours may require the amputation of the affected limb.
Stereotactic Radiosurgery
This method of treatment is employed to treat peripheral nerve tumours in and around the brain. The radiation is delivered directly to the tumour cells without making any incision.
Other treatments
If the tumour cannot be removed without damaging the adjacent nerves and tissues, other treatment options are considered. In the case of cancerous peripheral nerve tumours, radiotherapy and chemotherapy may be considered to shrink the tumour and subsequently surgically remove the cancerous tissue.
Rehabilitation
After surgical treatment of peripheral nerve tumours, physical rehabilitation is necessary. A brace or splint is used to maintain the arm or leg in position for healing. Working with a physical or occupational therapist can also help the individual recover the function and mobility lost due to nerve damage or amputation of limbs.
Conclusion
Peripheral nerve tumours are heterogeneous types of tumours that can be benign or malignant. According to the 2021 WHO classification of the Central Nervous System, peripheral nerve tumours comprise unique conditions, each presenting with specific clinical, anatomical, molecular, and histological features. Visit Manipal Hospitals, Mukundapur, for comprehensive details on peripheral nerve tumours. Book an appointment with the best neurosurgeon today!
FAQ's
No, most peripheral nerve tumours are benign (non-cancerous). However, a small percentage can be malignant (cancerous), so a doctor needs to evaluate and monitor the tumour closely.
Yes, in some cases, peripheral nerve tumours may recur, especially if they are malignant or if they are associated with certain genetic conditions, such as Neurofibromatosis. Regular follow-up visits with your doctor are essential to monitor for recurrence.
If left untreated or if the tumour grows significantly, peripheral nerve tumours can lead to permanent nerve damage, which can cause long-term problems with muscle function, sensation, and mobility. Additionally, if the tumour is cancerous, it can spread to other parts of the body.
The prognosis for peripheral nerve tumours is generally good, especially for benign tumours. Most patients recover well after surgical removal and have little to no long-term complications. The outlook for malignant tumours depends on factors such as the tumour's size, location, and how early it is detected.
You can schedule an appointment at Manipal Hospitals, Mukundapur, by contacting us or visiting our website.
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