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.
Rs1.5 lakhs - 1.7 lakhs
Short course radiation therapy is the one of the most talked about subject in recent years and also a fascinating research zone. Hypofractionated radiation therapy is an old concept, but only in recent years with tremendous improvement in radiation therapy delivery technologies there is a significant visible surge in it’s applicability in clinical practice. Modern radiation therapy technology is capable of delivering high dose to the target while sparing majority of the adjacent critical structures. Hence, it is possible to deliver short course of treatment regimen with higher dose per fraction without increasing in toxicity. In brain tumours, radiosurgery with gamma-knife is considered standard of care in many of the clinical indications such as small meningiomas, acaustic schwannomas, residual low grade gliomas, AVMs and solitary/ oligo brain metastasis. Gamma-knife radiosurgery is in clinical practice for more than five decades.
There are several prospective and randomized studies (level I evidence) with long-term follow up data supporting the use of radiosurgery in these clinical indications. Other indications of radiosurgery are pituitary tumour, craniopharyngiomas, glomus tumours, chordomas and others. Robotic radiosurgery (CyberKnife®) is precision radiosurgery delivery system and an extension of gamma-knife system. CyberKnife uses the principle of gamma-knife, but with linear accelerator source instead of multiple cobalt sources. CyberKnife is capable to treating all tumours indicated for gamma-knife with similar accuracy.
This modern tool has some additional advantages from gamma-knife, such as
1) CyberKnife can use fractionated treatment, hence relatively larger tumours can be treated.
2) Require only thermoplastic mask, no need for invasive frame.
3) Has inverse planning system, can spare critical structure.
4) There is a ‘intra-fraction’ correction technology with imaging.
5) There is no need to change the source, hence may be more cost effective.
6) Can be used to treat extra-cranial tumours also. CyberKnife has a linear accelerator attached with a robot and is capable of treatment from various coplanar and non-coplanar field arrangements. CyberKnife has sub-millimeter accuracy and unmatched dose distribution.
The advanced technology behind CyberKnife uses image guidance technology and computer-controlled robotics to deliver and extremely precise dose of radiation to targets, avoiding the surrounding healthy tissue, and adjusting for patient and tumor movement during treatment. In conclusion, CyberKnife is an extension of gammaknife radiosurgery delivery system. This machine has immense promise to treat with short course regimens with high dose and improve local control without increasing toxicities. If you wish to discuss about any specific problem, you can consult an Oncologist.
Acoustic neuroma refers to a tumour that grows on the main vestibular nerve connecting the inner ear to the brain. This nerve has a direct influence on both hearing and balance. This is a very slow growing tumour that is non-cancerous in nature. It is also known as a vestibular schwannoma. If left untreated, the pressure an acoustic neuroma puts on the nerve can cause a loss of hearing and unsteadiness.
An acoustic neuroma grows very slowly and hence the symptoms can often be very subtle. In many cases, this condition goes undetected for a very long time. Symptoms of an acoustic neuroma usually are a result of tumours effect on balance and hearing. A tumour may also put pressure on the nerves controlling the facial muscles and adjacent blood vessels. Thus, symptoms are usually noticeable only after a tumour has grown quite big. The most common symptoms associated with this condition are:
Acoustic neuromas are easily treatable. Treatment for this condition usually takes the form of surgery to remove a tumour or radiation therapy. This too is suggested only if a tumour grows large enough to have serious symptoms. For small tumours, doctors usually simply observe the growth rate of a tumour and prescribe medications to relieve the symptoms if any. However, this condition should never be ignored as in a few cases, the tumour can grow very large and affect the brain stream. It can even be life-threatening in such cases. In case you have a concern or query you can always consult an expert & get answers to your questions!
Like most other organs of the human body, the brain too is susceptible to cancer. Brain cancer is typically the result of abnormal growth of primary brain cells or the spreading of cancer cells that originated in another organ of the body. This is known as secondary or metastatic brain cancer. Depending on the stage it is diagnosed in, brain cancer can be cured. Let’s take a closer look at primary brain cancer.
Primary brain cancer or the development of tumours in the brain is fairly uncommon. However, they may attack children and adults alike. There are many different types of brain tumours. Their names depend on the part of the brain affected or the type of cell they originate from. The most common types of brain tumors are meningiomas, gliomas, pituitary adenomas, primary CNS lymphomas, vestibular schwannomas and medulloblastomas. Each of these tumors grows at a different rate and causes different symptoms. However, they can all be graded on the same stages.
In this stage, the cell growth is usually very slow. These cells look very similar to normal brain cells and the tissue is benign.
When cancer reaches this stage, the cells begin to grow at a faster pace and look a little different from normal brain cells. The tissue also turns malignant at this point.
The abnormal cells or tumor begins to grow actively and take on a completely different look as compared to normal brain cells. These calls may also be termed as anaplastic.
This is the most aggressive stage of brain cancer. At this stage, the cells begin to grow at a very fast rate.
Treatment for brain cancer depends on a number of factors including the size of the tumor, cancer stage, patient’s overall health, age and any other medical issues that may be present. Brain cancer can be treated with drugs, surgery, radiation and chemotherapy. Two or more of these forms of treatment are usually used together for faster and better results.
Whenever possible, a doctor will try to remove the tumor surgically. This may be preceded by drugs to prevent seizures and relieve swelling in the brain. Patients who cannot undergo surgery may be given radiation instead. This form of therapy uses high energy rays to kill the cancer cells. Radiation may also be used after surgery to kill any abnormal cells that could not be removed surgically. Radiation for brain cancer may be given externally or internally. Chemotherapy can also be used to treat brain cancer. This involves delivering medication orally or intravenously to kill the tumors. Each cycle of chemotherapy usually lasts a few weeks and is followed by a rest period. The results of chemotherapy are usually visible after 2 or 4 cycles.