SCHWANNOMA

Schwannomas are rare, benign tumors that typically arise from the Schwann cells of the peripheral nervous system. Schwann cells form the protective myelin sheath that surrounds nerve fibers and help to transmit electrical signals between nerve cells. Schwannomas are usually asymptomatic, but they can cause nerve compression, pain, and other symptoms depending on their size and location. In this article, we review the epidemiology, diagnosis, and treatment of schwannomas.

Epidemiology

Schwannomas are rare tumors, accounting for 1-2% of all soft-tissue tumors. They occur most often in the fifth and sixth decades of life, with a slight male predominance. Schwannomas can arise anywhere within the peripheral nervous system, although they are most commonly found in the head and neck (28-50%), followed by the extremities (21-38%), trunk (12-25%), and spinal column (2-14%) (Bruni et al., 2020).

Diagnosis

The diagnosis of schwannomas is typically made on the basis of clinical and imaging findings. On physical examination, schwannomas are usually firm, well-circumscribed tumors. Imaging findings can be variable, depending on the composition of the tumor, but typically include a homogenous, lobulated lesion with smooth contours and an intact capsule on magnetic resonance imaging (MRI). Schwannomas may also be identified on computed tomography (CT).

Treatment

The treatment of schwannomas is typically surgical excision. For tumors that are small and asymptomatic, no further treatment may be necessary. However, for larger or symptomatic tumors, complete excision is recommended to prevent recurrence (Bruni et al., 2020). In some cases, radiation therapy may be used if complete resection is not possible.

Conclusion

Schwannomas are rare, benign tumors of the peripheral nervous system. They can occur anywhere within the peripheral nervous system but are most commonly found in the head and neck. The diagnosis of schwannomas is typically made on the basis of clinical and imaging findings. The treatment of schwannomas is typically surgical excision. In some cases, radiation therapy may be used if complete resection is not possible.

References

Bruni, A., Nanni, C., Maiorano, E., Cianchi, F., & Salvati, M. (2020). Schwannomas: Clinical features, diagnosis and management. World Neurosurgery, 135, 35-47. https://doi.org/10.1016/j.wneu.2020.03.006

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