Peripheral Nerve: Neurofibrosarcoma and Rare Tumors

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Peripheral Nerve:  Neurofibrosarcoma and Rare Tumors




Guest:  Dr. Abhay Varma – Neurosurgery

Host:  Dr. Linda Austin – Psychiatry


Dr. Linda Austin:  I’m Dr. Linda Austin.  I’m interviewing Dr. Abhay Varma who is Assistant Professor of Neurosurgery here at MUSC.  Dr. Varma, let’s talk, now, if we could, about malignant or more serious tumors of the peripheral nerves, the nerves that are out in the arms and legs, away from the spinal cord.  What are the names of some of those rare tumors?


Dr. Abhay Varma:  The common rare malignant tumor which can afflict peripheral nerves is what is called neurofibrosarcoma.  It’s very rare compared to the benign tumors that we talked about in a previous podcast, namely, the neurofibromas and schwannomas, but it is known in certain genetic conditions to be more common.


Dr. Linda Austin:  So, it’s the most common of the rare tumors?  That sounds like, kind of, an oxymoron.  Do you know how common that is in the population?


Dr. Abhay Varma:  It is difficult for me to give a number.  But, in certain conditions, like neurofibromatosis, it is more common than in folks who do not have neurofibromatosis.


Dr. Linda Austin:  Is this typically a tumor in children or adults, or elderly?


Dr. Abhay Varma:  It generally develops in patients with neurofibromatosis, I would say, later in life.  I would say, after the second or third decade.


Dr. Linda Austin:  In a patient with neurofibromatosis, where you have so many tumors anyway, how do you even realize that one of them happens to be malignant?


Dr. Abhay Varma:  If it starts growing rapidly and is associated with pain, swelling and redness in that area, then the suspicion is, obviously, that it could a malignant process.  Then, really, it’s our responsibility to make sure that we are not missing one.


Dr. Linda Austin:  So, I’m sure, then, you remove that tumor, is that right?


Dr. Abhay Varma:  Yes.  We have to go in for a biopsy and, sometimes, you know, if the tumor has really spread out, it may even involve sacrificing the limb.


Dr. Linda Austin:  And how about radiation or chemotherapy?  Are they indicated?


Dr. Abhay Varma:  They would be, depending on how much the tumor has spread.  If it has spread beyond its local confines then it would require adjuvant therapy.


Dr. Linda Austin:  Are there any other malignant tumors that you see from time to time? 


Dr. Abhay Varma:  It is very unusual to see other kinds of malignant tumors involving the nerves.  Right now, I can’t think of any others coming from nerves.


Dr. Linda Austin:  Well, thank you very much.


Dr. Abhay Varma:  You’re welcome.


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