Our Summary

This research paper discusses neurofibromas, which are non-cancerous tumors made up of different cells from the peripheral nervous system. These tumors often infiltrate between nerve bundles and lack a clear outer layer. On MRI scans, they often appear less intense or equally intense compared to the surrounding tissue, and are usually brighter on T2 images, often presenting with a “target sign”, and are highlighted when a contrast agent is used.

The paper also includes a video showing the complete surgical removal of a neurofibroma that was causing pain in a patient’s popliteal fossa, the area behind the knee. When making incisions, it’s crucial to cut either diagonally or in a zigzag across a skin fold, never directly perpendicular to it. It’s also important to expose the normal nerve above and below the tumor. The patient who underwent this procedure had a good recovery. The video of this procedure can be found through the provided link.

FAQs

  1. What is a neurofibroma and where does it develop?
  2. How is a neurofibroma identified on an MRI?
  3. What is the process of gross-total resection of a peroneal nerve neurofibroma?

Doctor’s Tip

One helpful tip a doctor might tell a patient about tumor resection is to follow all post-operative care instructions carefully, including keeping the surgical site clean and dry, avoiding strenuous activities, and taking prescribed medications as directed. It is also important to attend all follow-up appointments to monitor recovery and ensure that the tumor has been completely removed.

Suitable For

Patients who are typically recommended for tumor resection include those with symptomatic tumors causing pain, neurological deficits, or other functional impairments. In the case of neurofibromas, surgical intervention may be necessary if the tumor is growing rapidly, causing significant symptoms, or if there is concern for malignant transformation. Additionally, patients with tumors that are causing compression of nearby structures or organs may also be recommended for tumor resection. Ultimately, the decision to undergo tumor resection should be made in consultation with a healthcare provider who can assess the individual patient’s specific situation and determine the most appropriate course of action.

Timeline

Before tumor resection:

  • Patient experiences symptoms such as pain and a palpable mass in the affected area
  • Diagnostic imaging, such as MRI, is performed to confirm the presence of the tumor
  • Surgical planning is done to determine the best approach for tumor resection

After tumor resection:

  • Patient undergoes the surgical procedure, which may involve incisions across a skin crease to minimize scarring
  • The tumor is removed, and care is taken to expose normal nerve tissue surrounding the tumor
  • Post-operative care is provided to the patient to ensure proper healing and recovery
  • Follow-up appointments are scheduled to monitor the patient’s progress and assess functional outcomes

What to Ask Your Doctor

  1. What is the location of the tumor and how will the surgery be performed?
  2. What are the potential risks and complications associated with tumor resection surgery?
  3. How long is the recovery process expected to be and what can I expect in terms of pain management?
  4. Will there be any long-term effects or limitations after the surgery?
  5. What are the chances of the tumor coming back after resection?
  6. Will I need any additional treatments or follow-up care after the surgery?
  7. How will the surgery affect my overall quality of life and function?
  8. Are there any alternative treatment options available for this type of tumor?
  9. What is the success rate of this type of surgery for this specific tumor?
  10. Can you provide me with any additional resources or information about tumor resection surgery?

Reference

Authors: Haldeman C, Hanna A. Journal: Neurosurg Focus. 2018 Jan;44(VideoSuppl1):V2. doi: 10.3171/2018.1.FocusVid.17546. PMID: 29291298