Neurofibroma is a tumor formed from the multiplication of neural or perineural tissue. It is a tumor commonly presenting on the skin in the form of bump or swelling. Neurofibromas are soft inconsistency which is because of the absence of collagen in the dermis layer of the skin. Neurofibromas are benign so the common cause of the treatment-seeking is the appearance of the tumor. It is a cosmetically bad looking tumor which troubles the patients.
Can Neurofibromas Be Removed?
It is easy to treat a case of neurofibroma alone than if associated with neurofibromatosis. Surgical removal is the treatment of choice in neurofibromas. Surgical removal 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. Scarring can be seen after the healing but its reduction can be the with careful excision and fine suturing by expert hands.
After the advent of laser therapy, treatment is preferred by the patients with it because of fewer side effects. Laser treatment also provides precise removal because robotic precision is far better than human precision which helps in reducing scar marks to further extent.
Medical treatment has proven to be a failure in the neurofibroma cure. Even widespread research work has not yielded good results in medical therapy. There is no recognized drug developed till today which could treat the neurofibroma tumor. Although other anticancer drugs like carboplatin and vincristine are usually used as palliative treatment for patients suffering from these tumors in incurable cases[1].
Do Neurofibromas Grow Back?
Generally, the reception of the neurofibroma is successful without having complication but many cases are noted with recurrence. According to data provided by the research, the recurrence rate of neurofibromas is found to be as high as 10%. A few cases have been seen getting converted to a hereditary syndrome of neurofibromatosis after the removal of the neurofibroma surgically[2]. The recurrence rate is higher when associated with genetic disorders like neurofibromatosis and is lesser when occurs alone. Laser treatment is also thought to be more favorable for recurrence than the surgical treatment because of more chances of leaving the remnant tissue in the site.
After the recurrence sometimes they may undergo enlargement to form plexiform neurofibroma or even turn malignant due to the surgical injury incurred on the tumor. If the tumor has recurred, then again the surgical treatment of the tumor could be done after investigating about the malignancy of the tumor. If the recurrence is after laser treatment then surgical resection would be preferred treatment of choice for removing neurofibromas.
Regular follow up is required to assess the area of resection and detect the early growth or nodule formation. Usually, patients are recalled every 6 months or 1 year for the examination. Not only the site of the surgery should be checked but also the whole body is needed to be screened to rule out new neurofibromas at any other site. It reduces the chances of further complications and provides early care for the tumor.
Conclusion
Neurofibromas are a treatable type of tumors because of benign nature. These can also occur as a dermatological manifestation of neurofibromatosis in both types. Complete surgical removal of the tumor along with affected part of the nerve is a treatment of choice for a neurofibroma. There is usually no further neurological deficit seen after the surgery. The already present neurological deficits can improve due to the development of collateral nerve supplies of the area. Medical therapy has not been the best of areas in the treatment of neurofibroma. No single drug is found till now which is helpful in reducing these tumors.
Recurrence rate it has been found to be high enough to rethink about the treatment approach and aggressive follow up is required to minimize the recurrence and complications. Early detection is the best preventive method in reducing recurrence.
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