Neurofibromas are benign tumors of the peripheral nerves. They arise from the cells that form and support the nerve sheath. These tumors infiltrate the nerve and disrupt the sheaths of individual fibers. They can occur as a single tumor or in groups. When multiple tumors appear, they are associated with neurofibromatosis, a genetic disorder also known as von Recklinghausen disease. Symptoms depend on the location and size of the tumor. They are typically painless, slow-growing masses, and may cause no symptoms. Spinal neurofibromas are rare, and comprise approximately three percent of all spinal tumors.
UPMC offers several options to patients with neurofibromas including surgical treatment and stereotactic radiosurgery.
The doctor will perform a physical exam and ask about any symptoms. Symptoms depend on the size and location of the tumor. These tumors typically are painless and slow-growing. Patients sometimes feel an electric-like shock when light pressure is applied to the tumor. If a motor or sensory nerve is involved, the associated function may be affected.
Symptoms may include:
Neurofibromas have a characteristic appearance on MRI scans. A biopsy of the tumor taken during surgery enables a positive diagnosis.
If symptoms suggest that the tumor is compressing the spinal cord, corticosteroids are immediately given in high doses to reduce the swelling. These tumors are treated as soon as possible, usually surgically. Because of the risk of nerve damage during surgery, tumors that are not causing symptoms may be left untreated.
Many neurofibromas can be removed surgically. If tumors cannot be fully removed, radiation therapy may be used to relieve pressure on the spinal cord. UPMC neurosurgeons may also treat neurofibromas with stereotactic spine radiosurgery, which is a minimally invasive technique that uses highly focused beams of radiation to target spinal tumors. The beams destroy the tissue that a surgeon would otherwise need to remove with a scalpel during a traditional operation. The precision of this surgery results in minimal damage to the healthy tissue surrounding the tumor, and a lower risk of side effects compared with traditional surgery.
Spine Radiosurgery: An Alternative Approach
Dr. Peter Gerszten discusses the advantages to spine radiosurgery treatment for patients.