Schwannoma: Treatment, Procedure, Cost and Side Effects

Synonyms for Schwannoma are Neurilemmoma, neurilemoma, neurinoma, neurolemmoma, Schwann cell tumour.

A schwannoma is a usually-benign nerve sheath tumor composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral nerves.chwannomas are homogeneous tumors, consisting only of Schwann cells. The tumor cells always stay on the outside of the nerve, but the tumor itself may either push the nerve aside and/or up against a bony structure (thereby possibly causing damage). Schwannomas are relatively slow-growing. For reasons not yet understood, schwannomas are mostly benign and less than 1% become malignant, degenerating into a form of cancer known as neurofibrosarcoma. These masses are generally contained within a capsule, and so surgical removal is often successful.

Treatment depends on where the tumour is in your body and whether it is benign or malignant (cancerous). Your specialist may monitor you carefully at first rather than suggest treatment. They will see your regularly and monitor any symptoms you have. This is because the treatment can cause a lot of side effects. The main treatment for schwannoma is surgery to remove the tumour. The type of surgery you have depends on where in the body the tumour is.You might also have radiotherapy and chemotherapy if you have a malignant tumour.

Usually, a schwannoma coming back in the same place means that it wasn't completely removed the first time round. There may have been microscopic traces of it left behind. This is enough for it to grow into a new tumour. It might happen because your surgeon couldn't remove any more than they did, due to its size or position in the body. When this type of tumour comes back, it can be more difficult to treat. You might have surgery again if it is possible to remove the new tumour. You might be able to have radiotherapy again depending on the dose you had previously.

Treatment of malignant schwannoma.These tumours can be difficult to treat. The main treatment is surgery, where the surgeon will try to remove as much of the tumour as possible and the surrounding tissue. Radiotherapy might also be used before or after surgery to try to shrink the tumour or to reduce the risk of it coming back.Malignant schwannomas don't respond very well to chemotherapy. Chemotherapy may be used to try to shrink the tumour or to keep it at bay, but it is usually unlikely to cure it. As these tumours are so rare there is not a lot of information about them.

Signs of a peripheral nerve tumor develop from direct effects on the main nerve or from the tumor pressing on nearby nerves, blood vessels or tissues. As the tumor grows, it may be more likely to cause signs and symptoms, although tumor size doesn't always determine effects.Signs and symptoms of peripheral nerve tumors vary depending on the location of the tumors and which tissues are affected. They include:Swelling or a lump under your skin,Pain, tingling or numbness,Weakness or loss of function in the affected area,Dizziness or loss of balance.

Schwannomas may grow slowly and may be present for months or years without causing symptoms. Therefore, some people may never experience any symptoms. Others may experience radiating pain, muscle weakness, tingling, a "pins and needles" sensation, or numbness, but symptoms vary depending on the peripheral nerve which is affected.

The following are examples of symptoms that may occur due to a schwannoma in a specific nerve or area of the body:Vestibular nerve (the nerve connecting the ear and brain) - hearing loss, dizziness, balance problems, and/or ringing or buzzing in the ear.Facial nerve - facial paralysis, swallowing problems, difficulty moving the eye, facial pain, and/or loss of sense of taste.If you do not face any of these, then you are not prone to Schwannoma.

Both noncancerous and cancerous peripheral nerve tumors can compress nerves, leading to complications, some of which may be permanent: Numbness and weakness in the affected area,Loss of function in the affected area,Difficulties with balance,Pain

Though your doctor will give you specific instructions, it’s important to start with an idea of what to expect during your at-home recovery following your acoustic neuroma surgery. You will likely be given a prescription for pain medication to help you feel more comfortable when you are discharged. You will likely feel tired and need to take it easy, so it can be useful to have someone help you with chores around the house and childcare, allowing you to focus on healing. couple of weeks following your surgery, your doctor may transition you from any narcotic pain medications to acetaminophen, depending upon your individual case. Although unlikely, some patients may be prescribed pain medications for up to a month to help manage any discomfort.

After your first month of recovery, you will likely be experiencing fewer and fewer headaches and your energy will have returned. You will still be under activity restrictions. Most patients can expect to return to work after six to 12 weeks, depending on your individual recovery.If you have been experiencing any dizziness or balance issues, your doctor may recommend home exercises to help ease your discomfort. If you have any facial weakness, you may be given a set of exercises to do to strengthen your facial muscles. If you have experienced any hearing loss, your doctor may suggest following up with an audiologist.

If you have had surgery for an extradural tumor bedrest is not necessary. Either ways, the goal will be to get you up and walking quickly.The next step is to switch from intravenous pain medication to oral pain medication, after which will begin gentle movement exercises with a nurse and a physical therapist. Once you have demonstrated the ability to eat, walk independently, which is typically 3-5 days after the operation, you will be discharged from the hospital.For most intradural tumors, you can expect to recover from the effects of the operation itself after 3-4 weeks.

It can cost anywhere between Rs1.5 lakhs - 1.7 lakhs

The vast majority of schwannomas occur by chance and as a single tumor. Regrowth (recurrence) of a schwannoma is unlikely following the complete removal of the tumor by surgery. If a schwannoma comes back in the same place, it may not have been completely removed by surgery. Even a microscopic piece of the tumor that remains in the body may be enough to allow it to regrow.Because schwannomas are almost always benign, it is very unlikely for a schwannoma to return in another part of the body (metastasize).If multiple schwannomas develop separately from one another (independently), they may be associated with an inherited condition, such as neurofibromatosis type 2 (NF2) schwannomatosis, or Carney complex. In all of these conditions, various other signs and symptoms are typically present.