Are Neurofibromas Hard Or Soft & Can They Shrink?

Neurofibroma is a three-word combination of ‘neuro’ pertaining to nerve, ‘fiber’ pertaining to fibrous tissue and ‘oma’ pertaining to the tumor. It is defined as a benign tumor arising from the neural or perineural tissue. It is usually a benign tumor but can be malignant in few cases associated with neurofibromatosis. Neurofibromas are soft inconsistency which is because of the absence of collagen in the dermis layer of the skin. Collagen in dermis provides the strength and hardness to the skin tissue. The dermis layer of the skin is rich in collagen and neural tissue normally and forms ridges to insert in the epidermis. It forms the external barrier of the body from the environment.

On compression, there is no resistance felt under the tumor due to soft consistency which is identified as analogous to a buttonhole hence neurofibromas are sometimes referred to as buttonhole appearance or buttonhole sign^[1]. Neurofibromas are not hard but can be firm when various neural bundles are involved and metastatic changes may have taken place in it which could be seen in cases of plexiform neurofibromas^[2].

Neurofibromas are benign so the treatment for them is not essential but the most common cause of the treatment-seeking is the cosmetic appearance of the tumor. The treatment of the neurofibromas is mainly surgical. Surgical resection of the tumor along the margins with minimal surrounding tissue is favorable because these are generally benign in nature and do not spread to local tissue or surrounding structures.

Surgical resection is associated with a very low recurrence rate and permanent treatment of the neurofibromas. Scarring can be seen after the healing of the defect created during surgery. Scar reduction can be done with careful excision and fine suturing with minimal margins or subcuticular sutures can be placed. Usually, plastic surgeons are consulted for their treatment without scar marks as the common cause is bad cosmetic appearance.

After the advancement of laser technology, the rate of surgical resection of the neurofibromas has gone down. Treatment with laser technology( carbon dioxide laser is being used commonly in it) is preferred by the patients because of fewer side effects and scar marks of it. Laser treatment also provides precise cutting of the tissue without any extra margin taken along with it because robotic precision is far better than human precision. The defect created after the laser is very small in comparison to surgical resection leaving away the only small scar.

Various medical treatments had been tried for the treatment of neurofibromas but not much success has been found in this area. There is no recognized drug developed till today which could reduce the size or shrink the tumor^[3]. Although anticancer drugs have been used in its treatment which reduces its spread and metastasis to an extent reduction is not possible by any medical treatment. Laser treatments could be done to burn the tissue inside the tumor which can be looked as resizing the neurofibromas. Many research projects are underway for finding the drug which could be beneficial in neurofibromas.

Neurofibromas are soft tumors arising from neural and fibrous tissues. These could be singular or multiple in number. These tumors are very troublesome due to their cosmetic appearance and have detrimental effects on quality of life. Their larger counterparts known as plexiform neurofibromas are more dangerous and difficult to treat because of associated malignant changes or syndromic associations with genetic disorders like neurofibromatosis 1 and 2.

Till now surgical resection it is the mainstay of treatment of neurofibromas. Emerging trends in the field of medicine have supported surgical treatment. After the advent of laser therapy, many numbers of cases are being treated with it due to better cosmetic acceptance and small scar formation. Although laser therapy is very costly in today’s world further technological advances will make the treatment more hopeful and cheaper in the near future.

References:  

Also Read:

• What Is The Best Way To Get Rid Of Neurofibromas?
• What Leads To Neurofibromas & Can They Be Cured?
• How long Will It Take To Recover From Neurofibromas & How Long Do The Symptoms Last?
• What Are The Ways To Prevent Neurofibromas & Does It Reoccur?
• What Are The Different Types Of Neurofibromas?