peripheral nervous system benign neoplasm

Peripheral Nerve Tumors: A Rare but Benign Condition

Peripheral nerve tumors, also known as peripheral nerve sheath tumors (PNSTs), are rare growths that form on the peripheral nerves throughout the body. These nerves branch out from the brain and spine, responsible for transmitting signals to various parts of the body.

Characteristics and Symptoms

• Peripheral nerve tumors are usually benign, meaning they are non-cancerous [1].
• They can cause symptoms if they press on the nerve in which they are growing or on nearby nerves, blood vessels, or other structures [5].
• Common symptoms include swelling or a lump under the skin, pain, tingling or numbness, weakness or loss of function in the affected area, and dizziness [1].

Types and Causes

• Peripheral nerve tumors can occur spontaneously and can be found in one small part of the nerve or along its entire length [7].
• They are rare in the general population, but certain types, including neurofibromas, are more common in people with genetic conditions like neurofibromatosis type 1 (NF1) [6].

Diagnosis and Treatment

• Peripheral nerve tumors can be diagnosed through imaging tests such as MRI or CT scans, as well as biopsy [9].
• Treatment options vary depending on the size, location, and symptoms of the tumor. In some cases, surgery may be necessary to remove the tumor and relieve pressure on surrounding nerves [5].

References

[1] Context result 1: Symptoms of peripheral nerve tumors include swelling or a lump under the skin, pain, tingling or numbness, weakness or loss of function in the affected area, and dizziness.

[2] Context result 4: A peripheral nerve tumor is a tumor that grows on peripheral nerves throughout the body.

[3] Context result 5: A benign peripheral nerve tumor can cause symptoms if it presses on the nerve in which it is growing or on nearby nerves, blood vessels or other structures.

[6] Context result 6: Peripheral nerve tumors are a heterogeneous group of mostly benign tumors that are rare in the general population. Certain types, including neurofibromas, are more common in people with genetic conditions like NF1.

[7] Context result 7: Tumors that form in the peripheral nervous system — peripheral nerve tumors — typically form spontaneously and can occur in one small part of the nerve or along its entire length.

[8] Context result 8: Peripheral nerve tumors are growths that form in or near nerves. Nerves are strands of tissue that transmit signals from the brain to the rest of the body.

[9] Context result 9: Neoplasms of the peripheral nervous system arise from the cellular sheath surrounding the nerve trunks, that is, the pluripotential Schwann cells and related elements.

Common Signs and Symptoms of Peripheral Nervous System Benign Neoplasms

Peripheral nerve sheath tumors (PNSTs) are typically characterized by a range of symptoms that can vary depending on the location and size of the tumor. Here are some common signs and symptoms associated with PNSTs:

• Swelling or lump under the skin: A palpable mass or swelling is often the first noticeable symptom, which may be painful when pressed [1][2].
• Pain, tingling, or numbness: As the tumor grows, it can cause pain, tingling, or numbness in the affected area due to pressure on nearby nerves [3][4].
• Weakness or loss of function: Depending on the location and size of the tumor, patients may experience weakness or a loss of function in the affected limb or area [5].
• Dizziness or balance problems: In some cases, PNSTs can cause dizziness or balance problems if they press against the spinal cord or nerves that control balance [6].

It's essential to note that these symptoms can be similar to those experienced by patients with other conditions. A proper diagnosis and consultation with a medical professional are necessary for an accurate assessment.

References:

[1] Oct 19, 2022 — A benign peripheral nerve tumor can cause symptoms if it presses on the nerve in which it is growing or on nearby nerves, blood vessels or ...

[2] Jul 18, 2024 — Symptoms · Swelling or a lump under the skin. · Pain, tingling or numbness. · Weakness or a loss of function in the affected area. · Dizziness or a ...

[3] by AK Uerschels · 2023 · Cited by 9 — The most common bPNSTs are schwannomas and neurofibromas. Their localization can cause various symptoms such as local swelling, motor deficits, ...

[4] Jul 19, 2024 — Swelling or a lump under the skin. Pain, tingling or numbness. Weakness or a loss of function in the affected area. Dizziness or a loss ...

[5] What are the symptoms of nerve sheath tumors? · Lump or mass under their skin that may be painful when pressed. · Muscle weakness. · Numbness. · Pain that's aching, ...

[6] Nerve sheath tumors include schwannomas, neurofibromas and others. They grow slowly but may eventually press against the spinal cord or nerve and cause pain ...

Diagnostic Tests for Peripheral Nervous System Benign Neoplasms

Peripheral nerve sheath tumors, also known as benign neoplasms, can be diagnosed using various tests and examinations.

• Imaging tests: Magnetic Resonance Imaging (MRI) is the preferred method for imaging peripheral nerve tumors [1]. MRI can evaluate and diagnose nerve sheath tumors in most cases [7].
• Computed Tomography (CT) scan: A CT scanner rotates around the body to record a series of X-ray images, which can help identify the tumor and surrounding tissues [5].
• Ultrasound: This non-invasive test uses high-frequency sound waves to create images of the internal structures, including nerves and tumors [4].
• Electrophysiological testing: This test measures the electrical activity of the nerves and muscles, which can help diagnose nerve damage or dysfunction [9].

Additional tests

In some cases, additional tests may be ordered to provide more information about the tumor and surrounding tissues. These may include:

• Positron Emission Tomography (PET) scan: This test uses a small amount of radioactive material to create images of the body's metabolic activity, which can help identify cancerous cells [8].
• Biopsy: A biopsy involves removing a sample of tissue from the tumor for examination under a microscope. This can provide a definitive diagnosis and help determine the type of tumor [9].

References

[1] Context 1: Jul 19, 2024 — You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms.

[2] Context 2: by A Pellerino · 2023 · Cited by 15 — Tumor diagnosis for most of cranial and paraspinal nerve sheath tumors is still primarily based on hematoxylin and eosin (H&E)-stained sections and some ...

[3] Context 3: They'll order imaging tests such as MRI, CT, PET or ultrasound based on which ones will provide better information about your potential tumor and surrounding ...

[4] Context 4: by AK Uerschels · 2023 · Cited by 9 — Diagnostic workup includes neurological examination, magnetic resonance imaging (MRI), ultrasound, and electrophysiological testing. Especially ...

[5] Context 5: Oct 19, 2022 — Tests · MRI . This is the preferred method for imaging peripheral nerve tumors. · CT scan. A CT scanner rotates around the body to record a series ...

[6] Context 6: Jul 18, 2024 — You may undergo a general physical exam and a neurological exam. Several tests may help pinpoint the cause of your symptoms.

[7] Context 7: In most cases, MRI can evaluate and diagnose nerve sheath tumors. In some cases, such as when there are concerns that the tumor may be malignant, the doctor may ...

[8] Context 8: They'll order imaging tests such as MRI, CT, PET or ultrasound based on which ones will provide better information about your potential tumor and surrounding ...

[9] Context 9: by JM Gilchrist · Cited by 15 — EVALUATION · Imaging · Electrodiagnostic testing · Biopsy ; BENIGN NON-NEOPLASTIC NERVE TUMORS · Neuroma · Ganglion cyst · Intraneural ...

Treatment Options for Peripheral Nerve Tumors

Peripheral nerve tumors, also known as peripheral nerve sheath tumors (PNSTs), can be treated with a combination of surgical removal, radiation therapy, and chemotherapy. The treatment approach depends on the type and location of the tumor, as well as its potential to become malignant.

• Surgery: Surgical removal is often the first line of treatment for PNSTs, especially if they are benign (non-cancerous). Gross-total resection, where the entire tumor is removed, is considered curative in many cases [2].
• Radiation Therapy: Radiation therapy may be used to treat malignant PNSTs or to reduce the size of a large tumor before surgery. Stereotactic radiosurgery can also be used to deliver precise radiation doses to small tumors [1].
• Chemotherapy: Chemotherapy may be considered for patients with malignant PNSTs, especially if the tumor has spread to other parts of the body. Systemic therapy, such as MEK inhibitors like selumetinib, can be used in cases of incomplete resection or in patients with NF1-related plexiform neurofibromas/MPNSTs [10].

Specific Treatment Options

• Schwannomas: Treatment for schwannomas typically involves observation and monitoring, with surgery reserved for tumors that cause symptoms or become cancerous. The treatment approach depends on the location of the tumor in the body and its growth rate [7].
• Malignant PNSTs: Addressing malignant peripheral nerve sheath tumors may involve multiple approaches, including radiation therapy, chemotherapy, and surgical removal.

References

[1] Jul 19, 2024 — Stereotactic radiosurgery is used to treat some peripheral nerve tumors in or around the brain. Radiation is delivered precisely to a tumor ...

[2] by A Pellerino · 2023 · Cited by 15 — Gross-total resection is the first choice, and can be curative in benign lesions; however, the extent of resection must be balanced with preservation of nerve ...

[7] Treatment for schwannomas includes observation and monitoring, and surgery for tumors that restrict movement, cause pain or other symptoms, or become cancerous.

[10] by A Pellerino · 2023 · Cited by 15 — Systemic therapy should be considered in incomplete resected plexiform neurofibromas/MPNSTs. MEK inhibitor selumetinib can be used in NF1 ...

The differential diagnosis for peripheral nerve tumors, specifically benign neoplasms, includes several conditions that can present with similar symptoms and characteristics.

• Pathologic lymph nodes: These can cause local swelling and may be mistaken for a peripheral nerve tumor (2).
• Metastasis: Cancer cells from other parts of the body can spread to the nerves, leading to tumors that may resemble benign neoplasms (2).
• Soft tissue tumors of non-nervous origin: Tumors such as desmoid tumors or lipomas can occur in soft tissues near the nerves and may be confused with peripheral nerve tumors (2).
• Other conditions: Various other conditions, including cysts, abscesses, or inflammatory lesions, can also present with symptoms similar to those of benign peripheral nerve neoplasms.

It's essential to consider these differential diagnoses when evaluating patients with suspected peripheral nerve tumors. A thorough medical history, physical examination, and diagnostic imaging studies (such as MRI or CT scans) are crucial for accurate diagnosis and differentiation from other conditions.

References: * [2] Uerschels, AK. Differential diagnosis of local swelling includes pathologic lymph nodes, metastasis, soft tissue tumors of non-nervous origin, and others. * [4] Rodriguez, FJ. Diagnostic criteria and differential diagnosis for the major categories of nerve sheath tumors are proposed, including neurofibroma, schwannoma, and others.