Peripheral nerve tumors
What is it?
Peripheral nerve tumors are divided into benign and malignant.
Benign tumors include:
· neurinomas (or schwannomas);
· single neurofibromas;
· multiple neurofibromas, characteristic of von Recklinghausen disease, which can develop into neurosarcomas.
Malignant tumors include:
· neurosarcomas (also called neurogenic sarcomas or malignant schwannomas);
· very rare neuroectodermal tumors (medulloepithelioma, neuroepithelioma, medulloblastoma of the peripheral nervous system).
Which are the symptoms?
Patients may have true swelling in the area of the tumor lesion or sensory disturbances, paresthesias (e.g., electric shock sensations, formication) or decreased strength, which can vary depending on the nerve affected.
How is it diagnosed?
Diagnosis is clinical, and tools such as ultrasound, conventional radiography, computed tomography and magnetic resonance imaging are used as needed.
Suggested exams
How is it treated?
From a surgical point of view, an important distinction must be made between tumors that can be completely removed without severing the nerve, whether benign or malignant, and those that cannot be removed except by resection of the damaged nerve.
Complete removal without severing the nerve does not result in significant postoperative impairment and is possible, for example, in neurinomas because these tumors are clearly delimited from the healthy nerve bundles. Neurofibromas, on the other hand, are typical benign tumors that cannot be removed without provoking neurological deficits after resection of the affected nerve because of the interpenetration of healthy tissue and nerve bundles.
In the case of malignant tumors proper, surgical interventions with more extensive resection are required.
Surgical interventions are performed either under plexic anesthesia, when the patient is conscious, or under general anesthesia, depending on the location, size, and type of tumor.
The average length of hospital stay varies from a few days, as in the case of benign tumors in certain arreas, to a week or more, as in the case of some benign tumors in more delicate areas or malignant tumors.
Where do we treat it?
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