Sporadic schwannomas and neurofibromas

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By Herbert B Newton MD

Sporadic schwannomas and neurofibromas are also known as or subsume Chitoneuroma, Neurilemmomas, and Perineural fibroblastoma. -ed.

In this clinical article, Dr. Herbert Newton of Ohio State University provides an in-depth review of the pathology, biology, clinical presentation, and treatment options for sporadic schwannomas and neurofibromas. These tumors arise from the nerve sheaths of cranial nerves, nerve roots, spinal nerves, and peripheral nerves. The most common location for schwannomas is the eighth cranial nerve, whereas neurofibromas more commonly arise along the spinal nerve roots. Maximal surgical resection is the treatment of choice for most tumors. Radiotherapy is only used in selected cases. Chemotherapy is still under investigation for therapeutic potential. Dr. Newton also reviews advances in the molecular biology and therapeutic approaches to these tumors.

Key points

  • Schwannomas are slow-growing extra-axial tumors that can arise from any cranial nerve or spinal nerve root. They most commonly arise from the eighth cranial nerve.
  • Surgical resection is the treatment option of choice for most tumors. Complete resection can result in a surgical cure.
  • In selected cases, radiosurgery may be as effective as surgery at local control of tumor growth.
  • Chemotherapy is not applicable to most schwannomas. Recent data suggest that anti-angiogenic treatment approaches may be helpful in selected cases.