What is a schwannoma?

Schwannoma (neurinoma) is a tumor that is formed from auxiliary cells of the nervous tissue, Schwann cells. Schwannoma can be either malignant or benign. Most often, this tumor is found in the head, neck, spinal cord, upper and lower extremities. Schwannoma is usually diagnosed in middle age. It is diagnosed more often in women than in men.

Typically, this type of tumor grows slowly and does not cause symptoms. However, as it progresses, it can put pressure on surrounding tissues, lead to severe pain, paresis, paralysis, hearing and vision impairment, and negatively affect the functioning of internal organs. The tumor is often located close to vital structures, so the disease must be treated in advanced centers, where experienced doctors work who use the latest and most effective treatment methods. MedTour will help you get to the best medical centers specializing in the treatment of neuromas.

Causes of schwannoma

The reasons why this type of neoplasm develops currently remain unexplored. It is known that this neoplasm is associated with a mutation in a number of genes on chromosome 22. These genes are responsible for the synthesis of a protein that inhibits the growth of Schwann cells. But at present it is unknown what exactly causes the malfunction of the genetic apparatus. It is believed that when schwannomas occur, the cause may be exposure to ionizing radiation and the influence of a number of chemicals. Other benign formations may also presumably contribute to the development of neuroma.

Symptoms and signs of schwannoma

Symptoms may vary depending on the location of the tumor and its size. If we talk about the most common symptoms, it is worth mentioning:

• pain in the area of the affected nerve;
• general weakness;
• swelling in the area of the nerve that was affected by the tumor;
• neurological disorders with symptoms characteristic of damage to a specific nerve.

Vestibular schwannoma – symptoms

One of the common types of neuromas is vestibular schwannoma (vestibular neuroma, acoustic schwannoma, acoustic neuroma). Vestibular schwannoma arises from Schwann cells of the auditory nerve and is a benign neoplasm. According to statistics, this tumor accounts for 7% of all head tumors.

The characteristic symptoms of vestibular neuroma in the early stages of its appearance are:

• tinnitus, in most cases unilateral, constant;
• hearing impairment;
• imbalances.

Then, as the tumor grows, it begins to put pressure on nearby nerves. As a result, the following symptoms may appear:

• pain from the affected nerve;
• feeling of pressure in the ear;
• dizziness;
• loss of sensitivity in some areas, for example, numbness in the face;
• trigeminal neuralgia.

With other types of schwannomas, symptoms may differ because as they grow, they will put pressure on other nerve endings and nearby tissues. For example, with schwannoma of the facial nerve, loss of taste, vision problems, and impaired facial sensitivity often occur. With trigeminal neuroma, weakness of the masticatory muscles and taste hallucinations appear.

Types of schwannoma

Doctors classify schwannomas depending on their location:

• head and neck;
• spine;
• spinal cord;
• upper limbs;
• lower extremities.

The most common neuromas include:

• schwannoma of the auditory nerve;
• trigeminal nerve schwannoma;
• schwannoma of the facial nerve;
• neck schwannoma;
• schwannoma of the brain;
• spinal cord schwannoma;
• schwannoma of the foot;
• Cauda equina neuroma.

There are also more rare neuromas, for example, mediastinal schwannoma, pelvic schwannoma, sciatic nerve schwannoma. In addition, schwannomas can be single or multiple, benign or malignant.

Benign schwannoma

Many schwannomas are benign, including acoustic schwannoma. They are characterized by slow growth and the absence of metastases. However, over time they can reach large sizes, put pressure on surrounding tissues and grow into them.

More often they are a neoplasm with clear edges of a dense consistency. Such tumors may not produce any symptoms for a long time and are discovered by chance. However, when such tumors are detected, doctors recommend removing them.

Malignant schwannoma

Malignant types of neuromas occur rarely. These are aggressive neoplasms that are difficult to treat. Such tumors, for example, include brachial plexus schwannoma. Malignant neuromas are most often localized in the torso area, less often in the head, neck and extremities.

Stages of schwannoma

Doctors usually distinguish four stages in the development of neuromas. If we consider the development of this type of tumor using the example of vestibular neuroma, the stages have the following features:

• First stage. The tumor is up to 1 centimeter in size and does not extend beyond the boundaries of the auditory canal.
• Second stage. The tumor grows up to 2 centimeters and spreads beyond the auditory canal.
• Third stage. The schwannoma is approaching the brain stem, but is not yet pressing on it. The tumor size is up to three centimeters.
• Fourth stage. The tumor puts pressure on the brain, the tumor grows more than three centimeters.

Diagnosis of neuroma

The most informative method for diagnosing schwannomas is MRI. Magnetic resonance imaging with contrast is usually used. This allows doctors to determine the size of the tumor, see whether there is swelling in the adjacent areas, whether there are signs of hemorrhage and other features of the condition. MRI with modern machines detects even very small tumors a few millimeters in diameter and their internal structure.

For neuromas that are located in soft tissues, doctors can use ultrasound diagnostics. In order to definitively confirm that the detected neoplasm is a neuroma, a biopsy is performed. This allows for a differential diagnosis that allows schwannomas to be distinguished from other connective tissue tumors, such as fibrosarcomas.

Molecular genetic diagnostics can be used to determine the exact characteristics of a tumor. You can do genetic testing in Ukraine in the LifeCode laboratory, where a full range of tests is performed for accurate diagnosis of neoplasms.

To undergo an examination using the latest diagnostic equipment and the most modern techniques, contact the MedTour coordinating doctor. Our specialist will help you find the best medical centers for the diagnosis and treatment of neuromas.

Treatment of schwannoma

Treatment tactics for schwannoma depend on the size of the tumor, its location, stage and the patient’s condition. Specialists may choose a watchful waiting strategy if the neuroma is benign and if it does not lead to disturbances in the functioning of the nervous system. As a rule, doctors resort to similar tactics if the patient is elderly or has other health complications. But in most cases, when a neuroma is detected, treatment is prescribed. Therapy for this disease may include surgery, radiotherapy, and chemotherapy.

Surgery

In most cases, doctors prefer surgical treatment when a neuroma is confirmed. Open surgery or minimally invasive methods may be performed. Minimally invasive microsurgical techniques make it possible to remove tumor tissue with maximum precision without damaging surrounding tissues and blood vessels.

Radiotherapy – Application of the CyberKnife system

If the tumor is not too large (up to 3 centimeters), radiotherapy may be prescribed. This technique is also preferred if the tumor is located in places that are difficult to reach for surgical intervention.

In this case, the tumor is exposed to high doses of ionizing radiation. The CyberKnife system provides high accuracy (the error in the latest devices is 0.2 mm). This makes it possible to influence the tumor and control its growth without injuring critical structures: nerve endings, blood vessels.

Chemotherapy

Chemotherapy may also be used to treat malignant neuroma. However, some forms of pathology may be resistant to chemotherapy drugs. Therefore, doctors always prescribe the drug individually after an accurate diagnosis. Chemotherapy is prescribed in courses; drugs and their dosages are selected individually, taking into account the characteristics of the disease and the patient’s condition.

Schwannoma after surgery

Surgery for neuroma is highly effective. In more than 95% of cases, the tumor can be completely removed. The risk of relapse with this disease is very low. For malignant forms, radiotherapy or chemotherapy may be additionally prescribed after surgery.

In some cases, complications may occur after surgery. For example, surgery to remove a vestibular neuroma can lead to hearing loss. However, if you undergo treatment in modern medical centers with qualified specialists, the risk of complications will be minimal.

Schwannoma – prognosis. Schwannoma survival rate

With benign forms of the tumor and properly selected treatment, the prognosis is positive. A person can return to a full life and live quite a long time.

For malignant neuromas, the five-year survival prognosis is 65-40%. However, even if you have been diagnosed with an aggressive form of pathology, today there are opportunities to select effective treatment. If you go to advanced medical centers, where doctors have been treating this pathology for a long time and use the latest approaches to treating this disease, this will help to significantly improve your individual prognosis.

The best clinics for the treatment of schwannoma

You have the opportunity to get treatment at leading medical centers for the treatment of schwannoma. For example, you can contact the neuro-oncology center of the Helios Hospital Berlin-Buch (Germany), University hospital LIV Istinye (Turkey) or the world-famous Samsung Medical Center (South Korea). On the MedTour platform you can see information about these medical institutions, read about the treatment methods that are used there, get acquainted with their achievements and ratings among global medical institutions.

For more detailed information on clinics, contact the MedTour coordinator. The medical coordinator will advise you free of charge on all questions of interest, tell you about prices and help you choose the best clinic option for your needs.

The best specialist doctors for the treatment of schwannoma

MedTour will help you find a specialist who deals with schwannomas. We collaborate with doctors from different parts of the world who have extensive experience and are considered the best in this medical field. The MedTour coordinator will provide you with detailed information about doctors and help you choose the most suitable option for you.

Published: 24.11.2023

Updated: 26.11.2023

Medical author:

Ilona Baidiuk

Medical author, Medical editor:

Natalia Segen