Peripheral Nerve Tumors

Conveniently Located to Serve Dallas, Fort Worth, and the entire State of Texas

Conveniently located to serve Dallas and Fort Worth

Dr. Nader Pouratian is able to diagnose and treat peripheral nerve tumors for patients in Dallas, Texas and beyond using a variety of methods. Peripheral nerve tumors can arise anywhere in the body. They grow in or on the nerves that communicate signals between the brain, spine, and other parts of the body.

The vast majority of peripheral nerve tumors are non-cancerous. The most commonly found peripheral nerve tumor in adults is called a schwannoma, followed by neurofibromas. These benign tumors may cause pain, numbness, tingling, or even weakness. But in many cases, they may not cause any symptoms at all. These are usually called “incidental” tumors, in which case nothing may need to be done except watch it closely.

What Is a Schwannoma?

A schwannoma is a tumor that originates from the Schwann cells of the nervous system. Schwann cells are the cells that cover or “insulate” our nerves to help them send signals quickly from one part of the body to another. To do this, schwann cells produce insulating myelin sheaths around neuronal axons in the peripheral nervous system.

Causes of Schwannomas

Most schwannomas occur sporadically, which means we don’t know why they happen. Because they can come up randomly and they are benign, we sometimes think of them like a mole on a nerve. Just like a mole, they are most often benign and unless there is something concerning, surgery may not be required. Genetic disorders like schwannomatosis, neurofibromatosis 2 (NF2), and Carney Complex can also cause schwannomas to form. These syndromes are usually accompanied by other signs and symptoms, like having numerous nerve tumors, having brain tumors, having problems with the eyes, or having dermatologic findings (like café au lait spots or freckling in the armpit or groin).

These tumors can appear at any age, and they are most commonly diagnosed between the ages of 20 and 50.

Symptoms of Schwannomas

In many cases, schwannomas are not symptomatic. People can discover them when getting imaging for another reason or because they feel a bump under the skin.

When a schwannoma becomes larger, it puts pressure on the nerves around it, causing symptoms such as the following:

  • Numbness
  • Tingling or a pins-and-needles sensation
  • Weakness in the muscles
  • Sharp, burning, or aching pains

The exact symptoms depend on which nerve is affected. A special kind of schwannoma is a vestibular schwannoma, also called an acoustic neuroma. These can be associated with hearing loss, ringing in the ears (tinnitus), balance problems, or facial weakness.

Good Candidates for Peripheral Nerve Tumor Treatment

If you are experiencing the symptoms associated with schwannomas, you may be a candidate for peripheral nerve tumor treatment. If tingling and numbness occur frequently in certain areas of your body, consult a neurosurgeon right away. Unexplained pain or muscle weakness should be reported right away.

Your Consultation with Dr. Pouratian

To diagnose schwannomas, Dr. Pouratian will meet with you for a consultation and may ask you about any signs and symptoms you are currently experiencing.

A thorough discussion of your medical history will take place to determine if you have risk factors. You will be asked if there is any history of cancer in your family, and any pre-existing conditions will be discussed, as will any medications currently being taken.

During this consultation, Dr. Pouratian will tell you more about schwannomas and the treatment options that may be right for you. This discussion will include walking you through the preparation and recovery process required after these treatments.

If Dr. Pouratian suspects a peripheral nerve tumor, he may recommend one or more of the following tests.

Tests Used to Diagnose Schwannomas

To diagnose schwannomas, Dr. Pouratian will meet with you for a consultation and may ask you about any signs and symptoms you are currently experiencing. If he suspects a peripheral nerve tumor, he may recommend one or more of the following tests.

Magnetic resonance imaging (MRI): An MRI scan uses radio waves and a magnet to give a 3-D view of the nerves.

Ultrasound: An ultrasound uses sound energy to create images of the nerve and is a particularly useful way to look at nerves and tumors.

Electromyogram (EMG) and nerve conduction studies: Small needle electrodes are inserted into certain muscles. An electromyogram records the electrical activity in the muscles as the patient tries to move the area. For nerve conduction studies, electrical impulses are delivered to the nerves through electrode patches.

Tumor biopsy: Cells are removed from the tumor and then carefully analyzed in a lab setting. For this procedure, patients may need local or general anesthesia.

These tests will help Dr. Pouratian decide on the best treatment approach for your peripheral nerve tumor.

Peripheral Nerve Tumor Treatment Options

Many schwannoma treatment options are available. Treatment options are chosen for patients depending on factors like the location of the schwannoma and whether or not it is growing or causing pain.

Observation: Peripheral nerve tumors grow very slowly, and sometimes stop growing. If a tumor is relatively small, is not causing symptoms, and has not yet grown on imaging, we may recommend just watching the tumor. Usually a repeat scan will be requested in 6 months.

Surgical removal of the schwannoma: Although we call these “nerve tumors”, these tumors can actually be surgically removed usually with very low risk in an outpatient surgery center. Just like a cable has many wires, a nerve has many fascicles. These tumors usually grow on a single fascicle, pushing the rest of the tumor out of the way. During a surgery, we open up the cable, push the other wires (fascicles) out of the way, and are able to completely remove the tumor without injuring the normal nerve. This surgery is performed using anesthesia. 

Radiation therapy: Radiation therapy is very effective at controlling tumor growth, usually with >90% tumor control. Because surgical removal is so effective and safe, we usually only consider radiation for those in whom surgery may be particularly difficult, due to the location of the tumor or other concerns. 

Recovery Period

After your treatment, you will need a short downtime and recovery period. Depending on the treatment you received and its outcome, you may need physical rehabilitation to improve mobility issues and functional limitations.
The location and size of the removed schwannoma will affect your long-term prognosis. Monitoring with regular check-ups may be necessary.

Regular checkups and follow-up scans can also be conducted every 6  months to help monitor peripheral nerve tumors and their growth.

Arrange a Consultation

If you are experiencing the symptoms of a schwannoma, arrange a consultation with Dr. Nader Pouratian for diagnosis of peripheral nerve tumors in Dallas. Dr. Pouratian will be able to recommend the proper course of treatment and can answer any questions you might have.

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