The best treatment for a peripheral nerve sheath tumor will depend on the imaging studies and biopsy results as well as the patient’s personal and family history.
Watch and Wait
If the peripheral nerve sheath tumor is not causing any symptoms, the medical team may suggest observation alone. The team will track whether the mass is growing and monitor the patient for any new symptoms. This conservative choice means that the individual will come in for regular checkups and repeat imaging scans to look for any changes in the tumor.
A specialist may recommend that the tumor should be removed surgically in certain cases:
If the mass is entwined with an adjacent nerve or structure, sometimes the medical team will recommend other treatments to avoid damaging healthy tissue.
Surgery for Peripheral Nerve Sheath Tumors
Surgical choices depend on the size, location, rate of growth of the tumor, and whether it is benign or malignant. The advanced treatment options performed at Weill Cornell Medicine Brain and Spine Center include microsurgery and stereotactic radiosurgery, with the goal of removing as much of the tumor as possible and preserving or restoring nerve function without damaging healthy tissue.
Microsurgery: Surgery is the preferred treatment for most benign peripheral nerve sheath tumors, since it offers excellent results. Surgery can be used on a tumor of any size and is sometimes the only option for larger tumors that are pressing on critical structures. Microsurgery is often recommended to remove all or part of a peripheral nerve tumor. Specially trained surgeons use microscopes and small surgical tools, often working closely with radiologists preoperatively to visualize highly detailed images of the nerve and surrounding structures.
Stereotactic radiosurgery: Neurological surgeons can direct highly targeted radiation beams at a tumor from multiple angles using a Gamma Knife, or other stereotactic radiosurgery equipment. Radiosurgery is not an option for all tumors, and it may not treat some of the symptoms caused by the tumor. Results are not immediate – the goal is to control growth of the tumor, or reduce it substantially, over a course of months or years.
In the rare cases when a peripheral nerve tumor is found to be malignant, Weill Cornell Medicine Brain and Spine Center’s neurosurgeons and radiologists will team up with oncologists to determine the best course of treatment for these aggressive tumors, which may include a combination of surgery, chemotherapy, and radiation therapy.
Reviewed by Ibrahim Hussain, MD
Last reviewed/last updated July 2022