Neurofibroma is a three-word combination meaning nerve, fibrous tissue and tumor. Neurofibroma is a tumor formed from the multiplication of neural or perineural tissue. Usually, the neurofibromas are of benign origin with minimal symptoms and occur singularly without any correlation with other systemic symptoms whereas neurofibromatosis occurs with a group of symptoms one of which can be the formation of neurofibromas.
Can Neurofibromas Become Cancerous?
Neurofibromas are very benign tumors with a soft consistency and no local spread. But not always are these benign, they can also turn into cancerous lesions especially when associated with one of the neurofibromatosis types. Plexiform neurofibroma which is a type of neurofibromas is characterized by continuous growth, increased involvement of local tissues and widespread neurological deficit[1].
Plexiform neurofibroma is commonly seen turning into cancerous tumors because of their progressive nature. Invasive neurofibromas are lesser-known but not uncommon. Malignant changes are seen with local tissue involvement and metastasis to distant tissues. Usually, the association with other tumors likes optic glioma; vestibular schwannomas, etc. is the more consistent feature in the malignancy of neurofibromas.
Surgical resection is the treatment of choice for neurofibromas. Scarring can be seen after the healing of the defect created during surgery. This scar tissue sometimes acts as triggers for recurrence and helps the tumor to undergo malignant transformation.
Does Neurofibromas Get Worse With Age?
Even being benign, the neurofibroma tumors are progressive in nature and grow on with advancing age[2]. Neurofibroma with the size of a pea at a young age can turn to the size of a walnut in old age. These also multiply in numbers to describe the extent of disease, progression of the disease, and sometimes malignancy of the tumors.
According to the research projects on neurofibromas and associated disorders, it is seen that these worsen over a period of time and with advancing age. If left untreated these can outgrow in number and can be very troublesome for the patient. Also after the treatment is not sought for them, there may occur necrosis within them due to the attack of the immune system on them and the necrosis can easily turn the benign lesions into malignant ones.
Although the age of presentation is more in childhood and teenage with the previously known cases of the disorder in the family, it also makes the disease more dangerous with time due to undergoing progression and worsening. The neurological deficit caused by neurofibroma tumors also increases due to the involvement of nearby nerves bundles in it. The multiplication of these tumors is common elderly people and has a much high number of tumors than the young patients who just have got the early symptoms of the disease with one or two tumors. The environmental triggers and factors are encountered by the passing age and accumulate in the body which may work in favor of progression of the neurofibromas.
Also, the multiple neurofibromas are having a very bad cosmetic appearance and prove detrimental to the quality of life. The treatment becomes difficult with the age because of multiplicity, lowered immunity and healing power of the body.
Conclusion
Benign nature of the neurofibromas is not a constant feature of it, as plenty of cases is seen getting converted into invasive and malignant tumors. Radiation exposure, environmental triggers, advancing age and severity of the association are some of the common factors responsible for the cancerous conversion. It could be detected by the biopsy from the tumors or assessing the resected part of the tumor.
Age progression has proven to be detrimental for the tumors and these are not belonging to the group which gets corrected itself by the age. Worsening with age has been proved by various studies and it points towards the need for early intervention in the disease. Early diagnosis and treatment of the tumor are necessary if high risk of malignancy is suspected. Unnecessary delays are not part of the wisdom in the treatment of neurofibroma.
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