Nerve sheath tumors are tumors arising from the nerve itself or from the surrounding structures , such as the Schwann prison cell . They can be classified into benignant nerve sheath tumors , the most vulgar being schwannomas and neurilemoma and malignant nerve sheath tumour known as malignant peripheral nerve sheath tumors ( MPNSTs ) . Nerve sheath tumors can be associated with inherit syndromes such as neurofibromatosis ( type 1 and character 2 ) and schwannomatosis or can be sporadic .
How Do You Treat A Nerve Sheath Tumor?
The handling of nerve sheath tumor involves surgery , radiation therapy , chemotherapy and/or combination of either or all of them depending on the type of tumor , whether benignant or malignant ; extent ; localisation ; clinical presentation and spread of the tumor .
Surgery : Surgical resection is the gold - measure for the treatment of nerve sheath tumors . The goal of the treatment is to completely excise the nerve sheath tumour with the saving of the associated face and surrounding healthy tissue paper . This provides dependable handling outcomes in terms of both local recurrences and remote metastasis . The OR of a schwannoma position less difficultness as the tumor originates from Schwann cells , which surround the axons and these tumors can be extirpated from the surface of the nerve without make any damage to the nerve itself . On the other helping hand , the surgery of a neurofibroma or malignant nerve sheath tumor is more complicated as these tumors get up from the spunk itself and unadulterated remotion of the nerve sheath neoplasm may cause permanent damage to the cheek , complete removal of the touch brass or limb amputation .
The prospect for malignant heart sheath tumour is also wretched due to increase probability of recurrence and metastasis .
Radiation Therapy : It is now an of import component of nerve sheath tumor treatment , in addition to surgery . This is peculiarly true for the discourse of malignant peripheral face case tumors . Radiation therapy can be either done pre - operatively , intra - operatively and post - operatively . High - dose radiation sickness therapy is also apply in the stage setting of peripheral face neoplasm or tumors found in or around the brain that helps in destroying the tumor without the need of operating theatre .
Pre - surgical radioactivity therapy helps with planning of accurate radiation , localization of nerve sheath tumour , smaller prerequisite of dose and volume of intervention .
However , it stimulate delay in combat injury healing and hold up in surgery . Radiation therapy post - operatively is good for prompt surgical procedure , less complications related to wound healing along with providing larger specimen for tissue diagnosis . However , it want large volumes of treatment , high requisite of venereal infection and seed surgical seam / scratch with potential nerve sheath neoplasm .
actinotherapy therapy can also be administered via catheter , embedding in the operative seam during resection or loading radioactive textile during peri - operative period of time . This kind of radiation therapy is known as brachytherapy . These methods provide saturated treatment in a focal area in accession to very little scathe to the surround tissue paper , and small quantity of Lucy in the sky with diamonds , overall . However , they may pose problems with wound healing .
Chemotherapy : Chemotherapy is useful in the stage setting of systemic disease in which the tumor is too little or too diffuse and where there are greater opportunity of metastatic disease . The use of chemotherapy may involve count professional and hustle as some of its side - effects may be irreversible .
Chemotherapy can be administer either pre - operatively or post - operatively . Pre - working chemotherapy provides immediate discourse of micrometastatic disease and the potential for tumor shrinking in certain tumors that are sensible to chemotherapy . Chemotherapy also helps radiosensitize some tumor , making both combined chemotherapy and radiation therapy synergistically advantageous , which further serve with limb - salvage surgery .
Chemotherapy is not indicated in littler nerve sheath tumors < 5 - 8 cm and also avoided in cases where the tumour is localized to local cutaneal or subcutaneous tissue paper . It is indicated for patient under the age of 65 years with limited aesculapian comorbidities and estimable cardiac function . Tumors that are high level , big and deep are typically treat with chemotherapy .
Prognosis Of Nerve Sheath Tumor
ripe outcome calculate on early detection and treatment of the tumour . Malignant mettle sheath tumour has greater prospect of return and metastases , thus poorer prognosis . benignant nerve sheath tumor has less chances of recurrence with no metastases , thus a right prospect .
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