Neurinoma on the spine: treatment, symptoms

Neurinoma of the spine

The neurinoma of the spine is a benign tumor from the myelin sheath of the spinal nerves - Schwann cells, and therefore has the second name - Schwannoma. The pathological process more often develops in patients of middle and older age, with predominantly affects women.

Causes and location of the disease

The true reasons for the appearance of schwann have not been studied so far. Long-term studies of scientists from many countries led to a genetic theory of the disease.

The mutation of the gene material under the influence of unfavorable factors of the external and internal environment leads to an uncontrolled division of the Schwann cells of the myelin sheath of the spinal nerves.

A gradual increase in neurinoma of the spine leads to compression of surrounding tissues, including the vertebrae and spinal cord.

Most often affects the cervical and thoracic spine, less often the tumor is localized in the lumbar region and the sacrum. The pathological process in the myelin sheaths of the cervical spinal nerves can proceed according to the "hourglass" type.

The tumor grows into soft tissues through the spinal vascular openings of the vertebrae and can easily be visualized under the skin.

In the lumbar region, the neoplasm for a long time remains unnoticed due to a large array of muscles, which makes it difficult to diagnose in the early stages of the disease.

The structure of the tumor

Neurinoma of the spine, like any benign tumor, has a capsule that does not allow it to sprout into surrounding tissues and metastasize to other organs.

Outwardly it resembles a dense knot of irregular rounded shape with a tuberous surface.

Depending on the structure, the neoplasm is divided into the following types:

• epithelioid schwannoma - characterized by a dense arrangement of cells with a small amount of fibrous tissue;
• angiomatous schwannoma - includes a large number of cavernous cavities, formed by pathologically dilated blood vessels;
• xanthomatous schwannoma - contains a variety of pigment (xanthochromic) cells.

The most common growth of schwannoma by the type of "hourglass" is found in the neck

The tumor can reach large sizes - up to 3-5 kg. The volume of neoplasm and its structure affect the technique of therapy.

The most common malignant course of neurinoma on the spine is found in the mediastinum and horse tail of the spinal cord, which is in the sacral region, which requires an early surgical interference.

Clinical picture

The disease is characterized by a long asymptomatic period. From the onset of the pathological division of Schwann cells to the first manifestations of the tumor can take several years and even a decade.

At the initial stages of the disease, the only sign may be discomfort or dull periodic pain in the area of ​​the spine.

With the growth of benign neoplasm and compression of surrounding tissues, the following symptoms occur:

• an increase in the intensity of the pain syndrome in the back, upper and lower extremities;
• a violation of sensitivity and motor activity below the lesion (hypoesthesia, paresis, in severe cases, anesthesia and paralysis);
• weakness of the muscles of the extremities, atrophy of muscle fibers;
• a feeling of numbness in the hands or feet, parasthesia (sensation of tingling, burning, "crawling");
• violation of the function of the pelvic organs (incontinence, feces);
• decreased work of the sexual sphere.

Large tumors that have reached a size of more than 5-7 cm, are probed under the skin in the form of densely elastic painless formations. Especially noticeable neurinoma of the cervical spine, where a large neoplasm can be localized in the supraclavicular fossa.

Diagnosis of the disease

Type of neurinoma when performing tomography

Slow progression of schwannoma and poor clinical picture lead to late diagnosis of a benign tumor.

Often, the pathological process is accidentally detected with spondylography of the spine - research through X-rays.

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At the same time neurinoma is visualized in the affected area of ​​the spine and changes in the structure of bone tissue caused by violation of trophic and blood supply.

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Therefore, it is extremely important when there is pain in the back area immediately go to the doctor to find out the cause of unpleasant sensations.

The main diagnostic methods for detecting schwannoma include:

• radiography of the spine;
• computed tomography (CT);
• magnetic resonance imaging (MRI);
• ultrasound (ultrasound);
• puncture of a tumor located in the soft tissues of the back.

The complex examination performed reveals localization of the tumor, its size, structure, degree of damage to the surrounding vertebrae and soft tissues.

Therapeutic tactics

We advise you to read:Is the spinal hemangioma dangerous?

With a small amount of schwannoma, conservative methods of treatment are used at the initial stages of the development of the disease.

These include the appointment of diuretics (mannitol), glucocorticoids (dexamethasone, prednisalone), muscle relaxants (midokalm), which reduce edema of the nervous tissue, slow down the growth of a benign tumor, have an analgesic act.

Treatment of neurinoma of the spine in a radical way consists in its removal by various methods.

The radio wave method (the Cyberknife system)

It is used for tumor size up to 30 mm, in old age with concomitant diseases, which are contraindications to surgical intervention, patient's refusal from surgical treatment.

The technique consists in irradiating the lesion with ionizing radiation that destroys atypical cells, without adversely affecting healthy tissues.

The therapy is performed under local anesthesia on an outpatient basis.

The system "Cybernozh" refers to the innovative treatment of neoplasms

Surgery to remove neoplasm with capsule

It is performed with a small tumor node size. In the operating room, a cut is made over the lesion under general anesthesia.

The neoplasm is carefully removed with the capsule, without traumatizing the nervous tissue of the spinal nerves.

In recent years, using a low-traumatic technique with the use of endoscopic techniques.

Surgery for the next removal of the tumor and capsules

It is performed with a large size of the neoplasm, which is accompanied by the fusion of the capsule with the surrounding tissues. In this case, first the capsule is dissected, the schwannoma is removed, followed by the removal of the envelope.

Surgical intervention is associated with a risk of nerve tissue damage and is most safe in the early stages of the disease.

With the localization of schwannoma in the region of the horse tail, it is seldom possible to carry out complete tumor excision, which often leads to a recurrence of the pathological process.

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Neurinoma of the spine refers to benign tumors with slow progression and rare malignancy.

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However, untimely diagnosis and therapy can lead to compression of the spinal cord, which is fraught with a violation of motor activity, up to the development of paralysis.

At the first symptoms of the disease it is necessary to consult a doctor for examination and the appointment of an adequate course of treatment.

A source: http://MoyaSpina.ru/bolezni/nevrinoma-pozvonochnika

Neurinoma of the spine

A neurinoma is called a benign tumor envelope, which consists of Schwann cells. Hence the second term of neurinoma - schwannoma. Pathology can arise from the spinal, cranial or peripheral nerves.

Neurinoma is a roundish, dense growth, around which there is a capsule. During the year it increases by one and a half to two millimeters, however, if the education is of a malignant nature, then intensive development begins.

Most often occurs in patients of the middle and older age group, mainly in women.

articles

• 1 How is it manifested
• 2 Diagnostics
• 3 Reasons
• 4 Treatment

As manifested

Immediately it is worth saying that neurinoma of the spine in the early stages is absolutely asymptomatic. One can live a happy life without knowing that there is an education on the spine, which in some way is dangerous for life.

The change in the form of education over time has a clinical manifestation. Symptoms:

• Pain syndrome in different parts of the spine;
• Sharp pains that are given to different parts of the body;
• Uncontrolled acts of emptying the bladder and intestines;
• Weakness in the muscles, their atrophy;
• Decreased motor activity;
• Numbness of the extremities located just below the affected area (sensation of tingling, burning, "goosebumps");
• Disturbance of sensitivity;
• Decreased sexual activity.

In some cases, partial or complete paralysis of the body occurs. And also the development of bone tissue disease.

Diagnostics

Diagnosing neurinic spine in the early stages of development with the naked eye is almost impossible because of the absence of symptoms.But on the X-ray study, the tumor is visible.

This method of diagnosing pathology allows you to see the neurinic spine, when it already has obvious signs. The reasons for the X-ray study are the symptoms mentioned above.

This is the problem, because from the onset of the disease to the manifestation of the first symptoms can take years, and sometimes decades.

The choice of tactics for treating neurinoma depends on her condition.

Therefore, the only way to save a person from a tumor is surgical intervention. Also sometimes conservative agents are used.

• We advise you to read:tumors of the cervical spine.

Before starting treatment, the doctor is required to conduct a series of medical studies, this is necessary in order to understand how is located neurinoma on the spine, its size and features, as well as whether it has not degenerated into a malignant education. For the diagnosis of neurinoma, the doctor needs to be:

• Ultrasound examination (ultrasound);
• Magnetic resonance imaging (MRI);
• Radiography;
• Computed tomography (CT);
• Biopsies.

If you suspect a neurinic spine, the doctor sends the patient to a radiography, but it is believed that computed tomography will give the best visualization of the pathology. The more research is done, the more information will be on the location of the neurinoma, its size and other data.

Causes

Neurinoma on the spine never appears just like that. However, until now the true causes of the appearance of the tumor have not been studied. It is impossible to say exactly why this disease occurs. One thing is clear: this is a consequence of the growth of Schwann cells.

At present, several factors that contribute to the formation of neurinoma:

• Radioactive radiation;
• Continuous exposure to chemicals;
• Presence of various kinds of tumors;
• Poor heredity;
• The presence of neurofibratosis of the second type.

There are three types of neurin:

1. Neurinoma of cervical spine;
2. Neurinoma of the thoracic spine;
3. Neuroma of the lumbar spine.

The phenomenon of a single education is quite rare, most often, manifestations of neurinoma are possible throughout the spine.

Treatment

After the diagnosis, the doctor prescribes treatment based on the results of medical research. There are three methods of treatment:

• Conservative;
• Surgical;
• Radiosurgical.

The conservative method is medical treatment. It is the most preferred method of treatment.Therapy is aimed at reducing the rate of tumor development, on the removal of the pain syndrome, as well as on the elimination of other symptoms.

The radiosurgical method is irradiation. Radical measure, is the strongest stress for the body. It is used only when the tumor and tissues of the spinal cord are inseparable from each other.

With proper and timely treatment, the forecast of neurinoma remains favorable, paralysis of the limbs and other complications occur in isolated cases. Therefore, if you have a suspicion of a neuritis, do not delay with a visit to the doctor.

by HyperComments

A source: https://pozvonochnik.guru/opuholi/nevrinoma.html

Neurinoma of the spine: symptoms, causes and treatment

Nervous-system structures are usually responsible for the work of all systems of organs. They are divided into two types: central and peripheral. The first type includes spinal and cephalic structures, and the second is nerves.

The latter type of tissue can be affected by cancer. Among such ailments, there is neurinoma of the spine.

Information about the disease

This disease is a benign tumor. It is formed in Schwann cell structures.

A neuromuscular spine is a neoplasm in the structures of a cell that covers the nerve canals. The tumor most often has the form of a circle or capsule.

It arises more in the radicular part of the organ of hearing. Further it can develop in the front part.

Very rarely this disease affects the jaw and eye nerves.

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Another way of calling neurinus schwanoma. This ailment occurs in about 10% of the total number of intracranial lesions.

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A neurinoma of the spine takes one fourth of the total number of tumors of this part of the body. The disease can develop on the shell of absolutely any nerve.

Types of ailment

Any schwannoma, including neurinoma of the spine, is a benign entity. It grows very slowly in size. But in practice there were cases when the disease was malignant, that is, it was transformed into a malignant tumor.

There are several main types of this disease:

1. Schwannoma spine. Among the formations, this species is considered to be the most common. Neurinoma of the spine represents a tumor on the spinal roots. Such formations can grow through intervertebral foramen. Usually it is characteristic of the neurinoma of the cervical spine. Because of the shank, deformations of the bones are formed. This consequence of the disease can be identified after spondylographic diagnosis.
2. Morton's neurinoma. It is benign and appears on the sole of one of the feet. Generally, it is formed between the 3rd and 4th toes.
3. Schwannoma of the brain. Non-malignant formation grows very slowly. It is separated from other structures by a shell in the form of a capsule.
4. Neurinoma of the auditory nerve. It can be both for young people and for older people. Appears only in one ear and grows extremely slowly.

There are also other schwannomas, such as tumors of the optic, trigeminal, peripheral nerve.

Causes of the disease

Because of what develops this ailment, it is impossible to say to the end.

Usually doctors say that any schwannoma, for example, neurinoma of the spine of the lumbar region, is formed due to the growth of cells under the influence of gene mutations in the 22nd chromosome. The reasons for the latter, unfortunately, are also unknown.

But there are a number of factors that can affect the appearance of the disease:

• long-term effects of reagents and chemicals;
• strong radiation exposure at a small age per child;
• hereditary predisposition to the disease;
• presence of benign formations elsewhere;
• neurofibromatosis in a patient or someone from close relatives.

Heredity is considered one of the main causes of the disease.

Symptoms of neurinoma of the spine

There are no special signs that make it possible to distinguish shvanoma from other tumors.

With neurinoma of the spine, the main symptoms are:

• spinal cord lesions of the transverse species;
• pain syndrome;
• a vegetative disorder.

In the case where the front nerves are affected, paresis of muscle tissue and paralysis begins, and in the posterior nerves there is a violation of sensitivity, there is a sensation of creepy.

First signs of neurinoma of the spine either appear or disappear, but with the growth of the tumor the symptoms become permanent and strong. As a rule, pain increases when a person lies.

Thus, if these symptoms occur, you should consult your doctor to make the correct diagnosis.

Schwannoma and pregnancy

Usually, the disease is not a contraindication to conceiving and bearing a child. But there are cases when the tumor begins to grow rapidly in women in the position.

Experts advise to subject the neurinic spine to removal. After the surgical intervention, the pregnancy can be planned in a year.

Diagnosis of Schwannoma

For this, the patient is prescribed such procedures as:

• Magnetic resonance imaging. This examination can visualize the neurin in its formation at the very beginning.
• Radiographic diagnosis. It reveals the changes in bones that arise due to the growth of the tumor.
• CT scan. This procedure is done with a special contrast medium. It is this that allows us to consider tumors of small sizes.
• Ultrasound diagnostics. It is one of the safest and informative methods. The procedure allows visualization of soft tissue changes in the tumor region.
• Biopsy study. In this case, a piece of benign education is taken in order to histologically study it.
• metry. The procedure is used for neurinoma of the auditory nerve.
• Complex neurologic examination. It allows you to identify violations of the swallowing reflex, diplopia and paresis, and sensitive disorders.

Which of the diagnostic methods to choose for a patient is determined by a specialist.

Neurinoma of the spine: treatment

Therapeutic method is chosen based on where the tumor is located.

When neurinoma of the spine operation is mandatory in the following cases, when:

• there is an increase in symptoms or other symptoms;
• education is rapidly increasing;
• the tumor progresses after a radiosurgical operation.

There are a number of contraindications in which this method of treatment can not be carried out. So, in the presence of cardiovascular diseases, a serious condition of the patient or when the patient's age exceeds 65 years, surgical intervention is not allowed.

The operation involves removing the schwannoma by means of its excision.

When the tumor is located on the spine, the process of surgical intervention is without difficulty. These formations have a dense capsule and do not affect the shell of the brain.

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In the case where the tumor is fused with the fibers of the nerves, an operation is performed with a partial removal of it. Because of this, the patient may have a relapse. But this action prevents complications.

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In a number of cases, treatment takes place through stereotaxic surgery. Here a benign formation is irradiated, but surrounding healthy tissues are not damaged. This method of treatment has the least amount of side effects. But sometimes there is a relapse.

Consequences of surgical intervention

A dangerous moment of surgery when removing a tumor is the possibility of damage to the nerves. If all this does happen, then sensitivity and motor functions are disturbed.

With neurinoma of the auditory nerve, there is a possibility of hearing loss. This is not due to surgical intervention, but against the background of the pressure of education on surrounding structures.

Also, one of the most common complications of surgery is a muscle disorder, which is responsible for movement.

Treatment with folk remedies

The use of such methods contributes to the reduction of certain signs of the disease. But it should be remembered that with the help of folk remedies, a tumor can not be cured or it can not be removed.

Neurinoma can not dissolve itself only because of the use of broths. Therefore, do not delay the visit to the doctor, because in this way you will only aggravate the situation.

Also, serious consequences are possible. Therefore, when the first symptoms appear, go immediately to a specialist.

It is he who will help to prescribe the treatment and get rid of this ailment.

A source: http://.ru/article/356728/nevrinoma-pozvonochnika-simptomyi-prichinyi-i-lechenie

What is neurinoma of the spine: the causes of the formation and methods of its removal

Practically in any part of the body there can be a neoplasm, both benign and malignant.

One of the varieties of benign formations is neurinoma (Schwannoma) of the spine. Code on the ICD 10 - D36.1.

It consists of the myelin sheath of nerves of the spinal cord (Schwann cells).

Tumor process can develop at any age. Most of the pathology is affected by middle-aged and older women. The development of spinal neurinoma can occur for many years and do not make itself felt.

As a rule, neoplasm does not pose a great danger for the body as a whole. But due to the peculiarities of its location, the compression of CNS structures leads to a significant decrease in the quality of life of the patient.

Neurinoma can develop not only in the region of the spinal roots, but also cause damage to other nerve endings (eg, auditory ones).

Therefore, it is necessary to treat neurinas necessarily, so that it does not entail even more problems.

Causes and pathogenesis of development

The tumor has a dense consistency, oval or irregular, tubercular form. Surrounds the neurin fibrous capsule or connective tissue.

Thanks to such a capsule, the tumor does not germinate into surrounding tissues, does not metastasize.

Although this type of tumor is considered benign, one can not exclude its transformation into a malignant formation 100%.

Predisposing factors may provoke the onset of tumor growth:

• heredity;
• exposure to ionized rays;
• injuries leading to damage to the nerve roots.

The growth of the tumor is rather slow. When it reaches a large size, it can protrude beyond the spinal column. Neurinoma can reach a weight of several grams to 3-5 kg.

Most often it is formed in the cervical and thoracic areas. The process of tumor growth in the spinal nerves of the cervical region can develop according to the "hourglass" type.

It grows into soft tissues through the orifices of the vertebrae, it can be visualized under the skin.

Types of education

Isolate such types of neurinoma, based on their location:

• cervical;
• thoracic;
• lumbar.

In some cases, tumors are of a multiple nature and appear throughout the spine.

Based on the structure of schwannoma, we can distinguish the following forms:

• epithelioid- characterized by a dense placement of cells with a small amount of tissue fibers;
• angiomatous- has many cavernous cavities, which were formed due to pathological dilations of the blood vessels;
• xanthomatous- has many pigment cells.

Clinical picture

Before the first symptoms of schwannoma appear, many years can pass from the beginning of its formation. Therefore, pathology is characterized by a long asymptomatic course. At the initial stages of the development of the disease, dull pains in the affected area can periodically appear.

During the progression of the tumor, it squeezes surrounding tissues, which causes the appearance of negative symptoms:

• increased pain in the back, limbs;
• atrophy and muscle weakness;
• impairment of motor function and sensitivity below the localization of the tumor (paresis, paralysis);
• numbness in the limbs;
• parasthesia ("creepy numbness in the extremities, burning);
• dysfunction of the pelvic organs;
• sexual dysfunction.

If the tumor is larger than 5 cm in diameter, then it can be probed under the skin. It is dense, elastic, painful. Especially easy to visualize neurinoma of the cervical spine.

On a note!The appearance of symptoms of neurinoma of the spine should be an impetus to immediate diagnosis and treatment.

Diagnostics

Before the appointment of therapy, it is necessary to conduct a number of specific examinations, to clarify the nature of the neoplasm.

Necessarily carry out diagnostic measures:

• radiography;
• MRI;
• CT;
• electromyography;
• Ultrasound;
• puncture of the tumor.

Thanks to such research methods, it is possible to determine the location of neurinoma, its volume, structure, and the degree of damage to surrounding tissues.

Rules and methods of treatment of the disease

The doctor determines the tactics of treatment based on the results of the diagnosis. Much depends on the rate of progression of the pathology, its stage, size of education.

The neurin is affected in several ways:

• conservative;
• surgical;
• radiosurgical.

As a conservative therapy used special drugs that help slow the growth of education. As a rule, drugs are effective at an early stage of the disease.

These include diuretics (Mannitol), (Prednisolone), myolexanths (Midokalm, Sirdalud). It is necessary to observe the water-electrolyte balance, to reduce the consumption of salt and liquid.

Radical therapy options

A more effective method of treating neurinoma is its removal. There are several methods of excising a tumor:

• Radio wave (Cyberknife)- the operation is carried out if the size of the formation is not more than 3 cm. It is also recommended for elderly patients and for contraindications to surgical intervention. The affected area is treated with ionizing rays, which have a harmful effect on atypical cells. Before the operation, local anesthesia is done.
• Removal of neurinoma with capsule- effective for a small tumor. The patient is given a general anesthesia, an incision is made above the site of the localization of the education. Carefully remove the neurin with the membrane, avoiding trauma to the nerves of the spinal cord. Today, such an operation is performed using endoscopic instruments.
• Another removal of neurinoma and capsules- The indication for conduction is the large size of the tumor, its fusion with surrounding tissues. First, dissect the capsule, remove the neurin, then immediately remove the capsule.

At a surgical intervention there is always a risk of damage to the tissues of the nervous system. When placing a tumor in the zone of the "ponytail it is very difficult to completely excise it. This causes frequent relapses of pathology.

Neurinoma of the spine is a slowly progressing benign formation. If you find it in time and conduct adequate treatment, then you can get rid of the problem once and for all. But if the growth of the tumor continues, then it can cause compression of the structures of the spinal cord and impaired motor activity of a person.

A source: http://vse-o-spine.com/bolezni/drugie/nevrinoma.html

Neurinoma

Neurinoma or Schwannoma (C47) is a rare soft tissue tumor that affects the nerves, namely Schwann cells.

In most cases, it is benign, but there are also malignant variants.

Malignant schwannoma is otherwise called a neurosarcoma.

Oncology can occur in nerves in any part of the body. Neurinoma is predominantly single, but multiple lesions occur.

The most common localization sites for these tumors are:

• legs (in particular, sciatic nerve);
• arms (brachial plexus);
• back (neurinoma of the spine or spinal cord, originating from the nerve roots);
• head and neck (cranial nerves).

The schannoma of the auditory nerve is very common. Rare variants include tumors of the nerves of the mediastinum and retroperitoneal space.

The peripheral nervous system transmits signals from the brain and spinal cord (central nervous system) to the muscles and tissues of the body. An onco-tumor can compress and damage the nerve, causing various disturbances, even if it is benign.

Lymphatic metastasis of malignant schwannoma is rare. Hematogenous metastasis usually occurs at a late stage in the lungs or bones in 33-55% of patients. Also, the tumor spreads through a direct invasion of the surrounding tissue.

Classification of neurin

As noted earlier, the nerve schwannomas can be:

1. Benign.They represent a clearly delineated site, which grows very slowly and may not cause any disturbances. Benign neurinomas often affect the tissues of the neck, head, face, spine.
2. Malignant.Malignant nerve sarcoma can appear de novo or as a result of malignancy of a benign tumor. It is distinguished by the absence of clear boundaries, soft elastic consistency, faster growth rates and the ability to form metastases in other organs. Malignant neoplasm reaches a large size and is more difficult to treat. Typical locations of localization are the distal sections of the limbs (brushes, feet, forearm).

Benign and malignant neurinomas are similar in clinical symptoms. Therefore, sometimes they are very difficult to distinguish. Morphological verification is required to determine the diagnosis.

When the tumor becomes malignant, the degree of its differentiation varies:

• at first it has the first (high) degree of differentiation. Its cells practically do not differ from ordinary Schwann cells and are practically benign;
• for the 2nd degree (middle), there are more noticeable changes in the structure of tissues and acceleration of the rate of growth;
• 3 (low) degree of differentiation denotes the most aggressive neurogenic sarcomas.

There is also the 4th degree, which is appropriated to undifferentiated neoplasms. Their histogenesis is very difficult to determine. Most neurosarcomas refer to the 3rd degree of differentiation.

The causes of schwannoma

Most of the causes of neurin outbreak remain unknown, since tumors usually develop in healthy individuals.

The causes of nerve tumors in some cases are such genetic diseases:

• neurofibromatosis type 1 and type 2;
• schwannomatosis;
• the Gorlin-Golts syndrome.

Also, risk factors include cases of oncology in the family, ionizing radiation and injuries.

Symptoms of a malignant schwannoma

Common symptoms of neurinoma are:

1. the appearance of a palpable formation under the skin;
2. tenderness in this area (especially when pressing).

Onco-tumors on the arms and legs look like small formations of dense consistency protruding above the skin. A visible sign may not be if the nerve is damaged, which is deep in soft tissues.

The remaining symptoms of schwannoma are specific, they depend on the location of the pathology:

I. Neurinoma of the brainor cranial nerves (it accounts for 10-13% of the tumors of the cranial cavity).

Manifestations of neurinoma of the nerves of the brain can be very diverse, depending on which area will be damaged.

With the defeat of nerves located in the front of the skull, next to the sinuses, symptoms may occur in the form of unilateral obstruction of the nose, hyposmia, nasal bleeding, atypical pain, localized swelling face.

When influencing the orbital department, as a rule, there are exophthalmos, nystagmus, visual impairment.

The defeat of the glossopharyngeal nerve causes problems with speech and swallowing, dysphagia, and phonation.

The neurinoma of the auditory nerve (vestibular schwannoma) causes:

• hearing impairment or deafness;
• tinnitus;
• problems with balance;
• dizziness when turning the head;
• spontaneous nystagmus.

Attacks may be accompanied by nausea and vomiting. With the progression of the disease, pain is noted in the part of the face where the tumor is located, as well as numbness. Neurinoma can affect the abducent nerve, causing a symptom of diplopia.

Damage of the trigeminal nerve and its branches is accompanied by:

• severe pain (burning);
• numbness of those or other areas of the skin of the face (limited movement of the eyebrows, lips, chin, etc.);
• atrophy of the masticatory muscles;
• loss of taste, increased salivation.

Dysfunction of the musculature occurs late, when the third division of the trigeminal nerve is involved in the process. Growth within the cavernous sinus can lead to dysfunction of the cranial nerves.

At later stages, the patient has different neurological syndromes and intracranial pressure, accompanied by headache and nausea.

In severe cases, when the tumor compresses the cerebellum or brain stem, there are:

• convulsions;
• mental disorders;
• intellectual violations;
• violation of breathing and cardiac activity;
• ataxia;
• hypotension of the muscles of the hands and feet;
• change of visual fields.

II. The tumor of the nerves of the spine (is 20% of all tumors of this localization).

Symptoms of the shawanoma of the spinal cord can be back pain, numbness in the legs or hands, weakness in the limbs, or paralysis.

A common neurinoma of the cauda equina causes paralysis of the lower extremities, pain in the lower back, giving to the legs and buttocks, impaired bladder function (urinary incontinence, urinary retention) and intestines.

III. Schwannoma soft tissues of the hands or feet- problems with movement, weakness.

IV.

Schwannoma mediastinum - The manifestations of malignant schwannoma of the mediastinum include pain in the chest or thoracic spine, numbness in the hands, skin of the trunk or neck, change in voice (hoarseness), shortness of breath and swallowing, enlargement of vessels on the chest, swelling and blueing face.

V. Neurinoma of the lung- cough, shortness of breath, pain when breathing.

VI. Cervical neurinoma- swelling on the neck, problems with swallowing, numbness of the tongue, pain in the neck and shoulder.

VII. Mortenon's neurinoma- This tumor is located in the foot, so people complain of pain in the foot or toes. Also, the presence of a foreign body can be felt.

In each individual case, a combination of different symptoms can be observed. At first they are not so pronounced, but as the disease progresses, they become stronger.

Diagnosis of a tumor

Diagnosis of malignant schwannoma is difficult, because this tumor is rare, and the symptoms it causes are similar to other more common diseases.

To detect neurological disorders, special tests for sensitivity, reflexes, coordination of movements, etc. are carried out. So the doctor will be able to understand how the nerve is damaged.

To exclude other (not oncological) ailments and confirm the diagnosis, apply these methods:

1. Radiography. Classic signs of a malignant schwannoma on the x-ray are a well-limited mass that displaces contiguous structures without direct invasion of them. Cystic degeneration is typical, but hemorrhages and calcification are very rare. Radiography also examines the chest, mediastinum and spine.
2. Computer tomography. CT is not as sensitive in the diagnosis of neurinoma as MRI, but it is often the first study. CT is especially useful in assessing bone changes and searching for lung metastases.
3. MRI. It will help to determine the exact location of the neoplasm, its connection with the nerve and surrounding tissues.
4. Biopsy. A sample of the tumor is taken with a special needle and examined in the laboratory to establish its origin and malignancy. A biopsy is not required if the doctors are sure of the good quality of the neurinoma (it grows slowly, has clear boundaries).

Depending on the location of the lesion, additional studies may be necessary. For example, myelography is used to study the spinal cord and its structures (including the nerve roots), and audiometry, i.e., hearing examination, is prescribed in the defeat of the auditory nerve.

Treatment of neurinoma (schwannoma): benign and malignant

The treatment of schwannoma depends on the location of the tumor, the severity of the symptoms and whether the tumor is benign or malignant (cancerous).

Operative treatment

In benign, small formations that do not cause pain or other symptoms, they can apply expectant management: the patient is not treated, but only checked regularly with MRI. When accelerating the growth of the tumor or the occurrence of any complaints, surgical removal is performed.

Operation with malignant neurinomas is mandatory. Neoplasms are resected together with a small part of the surrounding tissue to increase the chance of radical removal.

In severe cases, limb amputation is required, but they are rare. Schwannomas in the early stages, as a rule, can be removed without damaging the nerve. Operations with neurinoma in the hands and feet are considered quite simple.

Complete surgical resection may not be possible due to the extensive nature of the tumor and its location (eg, neurinoma of the brain or cranial nerves).

Radiosurgery

When treating the spinal column of the spinal column, there are certain difficulties associated with the possibility of damage nerve root or spinal cord, therefore, instead of surgery, stereotactic radiosurgery. This is a non-invasive technique based on the effect of radioactive radiation (as in radiation therapy). The procedure is carried out using a special device called the "Gamma Knife which creates powerful radiation and directs it to a tumor. In this case, the human body is fixed in a specially constructed stereotactic frame, and the direction of the ray is calculated by the CT apparatus in order to exclude errors.

For 1-3 painless procedures, lasting 30-60 minutes, one can completely destroy a small tumor, but the result will be visible only after a few weeks.

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The tumor decreases in size and becomes inactive, and the surrounding healthy tissue practically does not suffer.

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Radiosurgery is also used to treat brain schwannoma, which is located in hard-to-reach areas.

Chemistry and Radiation Therapy for Malignant Schwannoma

For the treatment of malignant schwanom, it is advisable to use adjuvant radiation or chemotherapy.

Postoperative antitumor therapy must be prescribed on condition that:

• incomplete removal of schwannoma;
• large tumor size;
• presence of regional or distant metastases.

Additional radiation exposure and / or chemotherapy presumably helps to destroy the remnants of cancer, stop the growth metastases, reduce the risk of recurrence and prolong the life of the patient, but their effectiveness is not proven because of the lack of a large research. With inoperable neoplasms, irradiation is the main method of treatment of neurinoma.

There is no standard chemotherapy regimen for nerve tumors, but in some studies, a positive result was obtained from the use of high doses of Ifosfamide and Doxorubicin. The number of courses varies from 4 to 6.

As a symptomatic treatment of neurinomas, non-steroidal anti-inflammatory drugs, anesthetics, can be prescribed. For brain tumors that cause hydrocephalus, shunting is the method of choice.

Treatment of relapses

A few years after the operation, 50-55% of patients experience a relapse of the malignant schwannoma.

If the tumor returns in the same place, it means that it has not been completely removed for the first time. Perhaps, there were microscopic oncocells.

The recurrence of neurogenic sarcoma is more difficult to treat. Doctors can conduct repeated removal of neurinoma, radiation therapy or chemotherapy, depending on the dose that was used previously. Targeted therapy is also practiced.

Complications and consequences of tumors of nerves

Surgical treatment of malignant schwannoma usually quickly removes symptoms associated with nerve damage. But in neglected cases, such unpleasant consequences can remain as:

• muscle weakness (if the muscle can not return to its original state);
• persistent dysfunction of the pelvic organs;
• loss of hearing;
• irreversible paralysis.

Oncology of the brain is also dangerous by such phenomena as epilepsy, loss of vision, impaired coordination of motion, respiratory or heart failure.

Schwannoma malignant: prognosis

Benign tumors of the nerves do not lead to death, therefore the 5-year lifespan for such patients is 100%.

Even malignant schwannomas grow slowly, compared with other sarcomas, so the prognosis for them is very comforting. 5-year survival is from 3% to 6%.

If the operation is impossible, the forecast will be worse. The numbers are also affected by the localization of the tumor.

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Thus, for neurogenic sarcomas of the head and neck, the 5-year survival prognosis is lowest, it is between 15 and 35%.

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A source: http://onkolog-24.ru/nevrinoma.html