Tumors (neoplasms) of peripheral nerves and autonomic nervous system

Neurinomas (schwannomas)

Neurinomas (or schwannomas) formed from Schwann cells are benign tumors of various sizes - dense, spindle-shaped, or rounded nodes located along the nerve trunk. Clinically, neuromas are most often expressed by painful symptoms of irritation. Less commonly, schwannomas are accompanied by clinical signs of loss of sensory and motor function of the nerve or a combination of these symptoms. Palpation of a nerve tumor usually causes irradiation of pain and paresthesias along with the nerve branching at the periphery.

Surgical removal is reduced to exfoliation of a neuroma from a fibrous capsule, which is incised in the longitudinal direction, formed by connective tissue layers of nerves, with the maximum desire not to damage the nerve bundles passing through the thickness of this capsule. Usually, a nerve tumor during surgery is isolated bluntly without much difficulty, and only in rare cases, it is necessary to resort to partial removal (resection) of the nerve together with the tumor and the subsequent suture of the nerve (neuroraphy).

 

Malignant sarcomatous tumors

Malignant sarcomatous nerve tumors with infiltrative rapid growth are subject to wide resection together with the surrounding tissues. In this case, sometimes it is necessary to resort to amputation of the limb, however, in the case of such tactics, metastasis of the sarcomatous nerve tumor is often observed.

 

Melanoma

Melanoma (pigmented nevus) belongs to a group of tumors of nerve endings, formed from Schwann cells, sensitive bodies in the skin. Melanoma (pigmented nevus) can look like a birthmark ("mole") or an extensive flat or brown papillary tumor. In malignant melanoma, radical removal of the nerve tumor with all regional lymph nodes in combination with radiation therapy is indicated.

 

Multiple neurofibromatosis

With multiple neurofibromatoses, characterized by the development of many tumors of various sizes along the nerve trunks, which usually do not cause serious functional disorders, indications for surgery arise only when a single node begins to cause pain or a very large node puts pressure on neighboring formations.

 

Recklinghausen's disease

Recklinghausen's disease, or neurofibromatosis, is characterized by the presence of numerous intradermal nodules and tumors of various sizes, developing on thin nerve trunks and their cutaneous branches (neurofibromas and neuromas), age spots on the skin of a light coffee color, small hemangiomas and lymphangiomas. Occasionally, with Recklinghausen's disease (neurofibromatosis), neurofibromas and neuromas of the cranial nerves (auditory, trigeminal, etc.) are observed. Spinal root neurofibromas are also observed. These neurofibromas and neuromas can cause compression of the brain and spinal cord, and then there are indications for surgery in Recklinghausen's disease (neurofibromatosis).

 

Tumors of the autonomic nerves

Among tumors of the autonomic nervous system, there are benign (ganglioneuromas), relatively benign (ganglioneuroblastomas, pheochromocytomas, or paragangliomas), and malignant (neuroblastomas). Depending on the clinical manifestations of tumors of the autonomic nervous system, therapeutic tactics will be built.