One of the most fear-inducing things a doctor can tell a patient is that she has a tumor. It also immediately raises questions: How big? What’s the treatment? What will happen?
A very important question to answer early on is: What type of tumor are we dealing with? While different varieties of tumors affect different organs, tissues and body parts, one of the most important things to know is whether it is benign or malignant.
Malignant tumors are cancerous. They tend to grow rapidly, invade surrounding tissues and—later on—spread to other areas of the body.
Benign tumors, on the other hand, tend to grow more slowly and limit themselves to their area of origin. They, too, may cause problems, however many have few or no ill effects. Some don’t even require surgery.
Columbia University Medical Center/NewYork-Presbyterian Hospital neurosurgeon Dr. Christopher J. Winfree is working to find ways to answer the “benign or malignant?” question for peripheral nerve tumors. Dr. Winfree has a special interest and expertise in the surgical treatment of peripheral nerves—nerves that carry information from the brain and spinal cord to the rest of the body and vice versa.
In a study reported in the journal Neurosurgery, Dr. Winfree and Columbia neurosurgery resident Dr. Jonathan Yun discussed a type of tumor called a peripheral nerve sheath tumor. These growths involve the supporting, or connective tissue, cells that surround nerves.
The authors reviewed 50 cases involving peripheral nerve sheath tumors. They looked at various characteristics of each, focusing on traits such as whether the tumor was painful and the location of the tumor.
They also looked for the presence of schwannomatosis (named after German physiologist, Theodor Schwann who developed the “cell theory” in the 19th century and discovered the cells which envelope peripheral nerve fibers, now called Schwann cells in his honor).
Schwannomatosis is an inherited condition that causes multiple (usually benign) tumors on multiple nerves throughout the body. Finally, they looked at the appearance of the growths on MRI.
With this information they could develop a score for each tumor. Scores increased when the tumors had more malignant features, and lowered when they had traits more common in benign tumors.
Using this new system, a score can be calculated quickly, giving physicians a more accurate picture of the danger of any given tumor. Physicians rely on tools like these to help them make the best possible treatment decisions for their patients.
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