Tumours of peripheral nerves become evident as they start causing clinical symptoms such as pain and/or loss of sensation and/or motor weakness. Intraneural tumours are usually benign lesions such as cysts, lipomas, neurofibromata and schwannomata; rarely “malignant nerve sheath tumours” or other maligmancies are encountered. Nerve tumours may be isolated entities involving one peripheral nerve only, or less commonly, multiple as part of neurofibromatosis type I or II or schwannomatosis.
In removing nervous system tumours, it is important to preserve the function of the involved neural elements. Thus such surgical operations are conducted under intraoperative neurophysiological monitoring.
As a rule benign nerve tumours can be surgically removed with excellent functional results. However, in small circumscribed lesions near the spinal cord, Cyberknife radiosurgical treatment can arrest growth.
Biopsy of peripheral nerve tumours should be strongly discouraged, because of the risk of nerve damage and difficulties in diagnosis with small sample size. Thus, when diagnostic imaging has demonstrated a nerve tumour, consultation with a nerve surgeon is recommended.
Malignant tumours of peripheral nerves require an individualised multidisciplinary approach approach involving surgical resection and post-operative radiation and/or chemotherapy under the supervision of an oncologist.