What is Schwannoma? Is it something to be afraid of? Let's find out exactly

Sometimes you may feel something like a small lump somewhere on your body. Or you may feel tingling, pain, or just a strange feeling. One reason for these things is a condition called 'Schwannoma'. The name sounds a bit complicated and scary, doesn't it? But don't worry. In this article, we will talk about what this really is, why it occurs, is it dangerous, and what the treatment is.

What is Schwannoma?

Simply put, a schwannoma is a tumor. But it arises from a special type of cell in our body. We call it 'Schwann cells'.

Now you might be wondering what these 'Schwann cells' are. Think of the nerves throughout our bodies as electrical wires. These nerves carry messages from the brain to all parts of the body. There's a plastic sheath around that electrical wire for protection, right? Similarly, our nerves also have a sheath around them to protect them and help them carry messages faster. That sheath is made of 'Schwann cells'. So, for some reason, when these Schwann cells start to grow out of control, a tumor forms there. That's what we call a Schwannoma.

The good news is that most of these tumors are not cancerous (benign) . This means they do not spread to other parts of the body. And they often grow very slowly, sometimes over many years.

But, very rarely, that is, very rarely, these can also become cancerous (malignant). Then we also call them 'soft tissue sarcoma'. But that is very rare. In 90% of cases, these are present as a single tumor.

Where do Schwannomas most commonly occur?

These tumors can develop anywhere in the 'peripheral nervous system', the nervous system that carries messages from our brain and spinal cord to the rest of the body.

But there is a special type that is seen more often. It is called a 'vestibular schwannoma' . Some people also call it an 'acoustic neuroma'. This develops in the nerve that goes from our brain to our ear, which helps us hear and balance. This is also often not cancerous, and it is a slow-growing type.

In addition, they can also develop in the sciatic nerve in the leg, the brachial plexus in the arm, and the nerves in the lower back.

Is this a brain tumor?

This is a question that many people have. The answer is, it may or may not be. It depends on where the tumor is located.

The types we mentioned earlier, such as the 'vestibular schwannoma', arise in the nerves inside the brain. That's why it's considered a brain tumor. But because schwannoma can arise anywhere in the body, for example, in a nerve in an arm or leg, not all of them are brain tumors.

What are the symptoms of Schwannoma?

Because these tumors grow very slowly, they can sometimes go for years without showing any symptoms. If symptoms do appear, what they are will depend on where the tumor is and how large it is.

The table below lists some of the most common symptoms.

Specific symptoms that vary depending on the location of the tumor

• Vestibular Schwannoma: This is located in the nerve that connects the ear, and can cause hearing loss in one ear . It can also cause a ringing sound in the ear (tinnitus), dizziness, and loss of balance.
• Facial Nerve: If a tumor occurs in this area, it can cause difficulty swallowing, difficulty moving the eyes, changes in taste, or facial paralysis.
• Sciatic Nerve: If a tumor develops on the main nerve that goes to the leg, it can cause pain that travels from the back down the leg, similar to a backache or a 'disc problem' .

Why does this Schwannoma form?

In fact, 90% of these cases occur sporadically, without any specific cause . No specific cause has yet been found.

However, a very small minority may have genetic causes. For example, people with genetic conditions such as Neurofibromatosis 2 (NF2), Schwannomatosis, or Carney complex are more likely to develop more than one of these tumors. People with these genetic conditions have a defect in the genes that control tumor formation in their bodies.

How does a doctor find this?

When you go to see a doctor with symptoms, they will examine you and, if they suspect this condition, refer you for several imaging tests. Sometimes, this tumor may be found incidentally during a scan done for another reason.

The main tests used for this are:

• MRI (Magnetic Resonance Imaging) scan: This is the best and clearest test to detect a schwannoma. It uses a magnetic field and radio waves to take very clear pictures of the inside of the body. An MRI can help determine the exact location, size, and effect on nearby nerves.
• CT (Computed Tomography) scan: This uses multiple X-ray beams to take cross-sectional images of the body. Although not as clear as an MRI, it can also help in diagnosis.
• Ultrasound scan: This is used to look for things like small tumors, especially under the skin.
• Biopsy: Sometimes, the doctor may decide to take a small piece of the lump with a needle and examine it. This is called a 'biopsy'. This will confirm 100% whether it is actually a schwannoma or whether it contains cancer cells.

What are the treatments for this?

The treatment depends on several factors. Your doctor will consider things like the location of the tumor, its size, how fast it's growing, and your symptoms.

There are three main treatment options.

1. Observation (Observation / "Watch and Wait")

If the tumor is not cancerous, is growing very slowly, and you don't have any bothersome symptoms, your doctor may say, "Let's just wait and see." That means he or she will do things like MRI scans at regular intervals to see if the tumor is changing in size. If the tumor starts to grow or if you have symptoms, then they will start treating it.

2. Surgical removal (Surgery)

If the tumor is growing rapidly or if the symptoms are bothering you, your doctor may recommend surgery to remove it. Since these tumors grow in the sheath around the nerve, most of the time the tumor can be completely removed without damaging the nerve . However, in cases like 'vestibular schwannoma', there is a risk of some hearing loss after surgery.

3. Radiation Therapy

This is called stereotactic radiosurgery (SRS) . This involves using a large number of very precisely targeted radiation beams to destroy the tumor. It's like surgery, but without the use of a knife. Your doctor may recommend this treatment if the tumor is in a difficult or risky area for surgery (for example, near important blood vessels or nerves).

How is the situation after treatment?

In most cases, the prognosis is very good after treatment. Especially if the tumor is completely removed, the chance of it coming back is very low.

However, the extent of complications that may occur after surgery depends on the following factors:

• If the tumor is large
• If the tumor is located deep in the body
• If the tumor is located on the ulnar nerve, a major nerve in the hand

However, overall, the prognosis for schwannoma is very good.

Can't this be prevented from happening?

Unfortunately, there is no way to prevent schwannomas from forming, because as we mentioned earlier, they often form randomly and without any reason.

However, if you know that someone in your family has a genetic condition like neurofibromatosis 2 (NF2), it's a good idea to talk to your doctor about it. He or she may be able to refer you for genetic counseling.