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Nerve Tumor Removal

Nerve Tumor Removal

Nerve tumor removal is a surgical procedure performed to excise abnormal growths that develop in or around the peripheral nerves. These tumors may be benign (non-cancerous) or, less commonly, malignant (cancerous). Because nerves are responsible for transmitting signals between the brain, spinal cord, and body, tumors in these areas can interfere with nerve function, causing pain, weakness, numbness, or functional impairment. Surgery aims to remove the tumor while preserving as much normal nerve function as possible.

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Types of Nerve Tumors

Most nerve tumors occur sporadically without a clear cause. However, some are linked to genetic conditions such as:

  • Neurofibromatosis type 1 (NF1) and type 2 (NF2).
  • Schwannomatosis, another hereditary condition. Other contributing factors may include prior radiation exposure or a history of trauma to the nerve, although these are less frequent.

Symptoms

The presentation of a nerve tumor depends on its size, location, and whether it is pressing on nearby structures. Common symptoms include:

  • A palpable lump under the skin.
  • Tingling, numbness, or burning pain along the path of the affected nerve.
  • Muscle weakness or functional impairment.
  • Shooting pain or electric shock-like sensations when the area is touched.
  • In some cases, no symptoms at all—tumors may be discovered incidentally.

Indications for Surgery

Not all nerve tumors require immediate surgery. Small, asymptomatic, and slow-growing tumors may simply be monitored with imaging. Surgery is considered when:

  • The tumor is painful or causing functional deficits.
  • There is progressive enlargement on imaging.
  • Diagnostic uncertainty exists (e.g., ruling out malignancy).
  • There is a risk of permanent nerve damage if left untreated.
  • Malignancy is suspected or confirmed.

Surgical Techniques

The principle of nerve tumor removal is to remove the tumor completely while preserving nerve integrity and function. The exact technique depends on the type and location of the tumor:

1. Intraneural Dissection (for Schwannomas)

  • Schwannomas often grow on the surface of nerves and displace nerve fibers rather than invading them.
  • The surgeon carefully peels the tumor away from the nerve using microsurgical instruments and magnification, often achieving complete removal with minimal functional loss.

2. Segmental Resection (for Neurofibromas or Infiltrative Tumors)

  • Some neurofibromas grow within the nerve and are harder to separate.
  • In such cases, part of the nerve containing the tumor may need to be removed.
  • If feasible, the surgeon performs nerve repair or places a nerve graft to bridge the gap and restore continuity.

3. Excision of Malignant Tumors

  • Malignant peripheral nerve sheath tumors often require wide excision, removing not only the tumor but also surrounding tissues to reduce the risk of recurrence.
  • In some cases, limb-sparing surgery is performed; in severe cases, amputation may be necessary.
  • These procedures are often followed by radiation or chemotherapy.

Recovery and Rehabilitation

Recovery after nerve tumor removal varies depending on the complexity of the procedure and the nerve involved.

  • Hospital stay may range from same-day discharge to several days.
  • Pain relief is usually noticeable soon after surgery, though temporary numbness or weakness may occur.
  • Physical therapy plays a crucial role in regaining strength, mobility, and nerve gliding function.
  • If nerve repair or grafting is performed, full recovery may take months to years, as nerves regenerate slowly.

Most patients are able to return to normal activities after a period of rest, though heavy or repetitive strain should be avoided initially.

Risks and Complications

Although many patients do well after surgery, potential complications include:

  • Nerve injury leading to persistent weakness, numbness, or chronic pain.
  • Recurrence of the tumor, particularly in genetic syndromes.
  • Scar tissue formation causing tethering of the nerve.
  • Infection, bleeding, or wound healing problems.
  • In cases of malignancy, spread of disease despite surgery.

Careful preoperative imaging, skilled microsurgical techniques, and postoperative rehabilitation help minimize these risks.

Outcomes and Prognosis

  • For benign tumors such as schwannomas, surgical outcomes are usually excellent, with high rates of pain relief and nerve preservation.
  • Neurofibromas are more challenging due to their infiltrative nature, but surgery often reduces symptoms and prevents progression.
  • Malignant tumors carry a guarded prognosis, and outcomes depend on tumor size, location, and whether complete resection is possible. Long-term follow-up is essential.

Importance of Early Diagnosis

Identifying nerve tumors early improves treatment options and outcomes. Small benign tumors are easier to remove without damaging the nerve, while early recognition of malignant tumors allows timely treatment before they spread. Patients should seek evaluation for any unexplained lump, persistent nerve pain, or neurological changes.

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