Schwannoma

A schwannoma is a tumour of the tissue that covers nerves, called the nerve sheath. They develop from a type of cell called a Schwann cell. Shwannomas are non-cancerous (benign). You pronounce schwannoma as sh-wun-oma.

Schwannomas are not common. They are seen more often in adults than in children. 

Rarely, schwannomas may change to become malignant peripheral nerve sheath tumours.

Vestibular schwannomas (acoustic neuromas)

Vestibular schwannomas are the most common type of schwannoma. They are also known as acoustic neuromas. They grow in a nerve in the brain that controls hearing and balance. They are non cancerous.

These tumours do not spread to other parts of the body. And they grow slowly over several years. They are usually diagnosed in older adults.

Symptoms of vestibular schwannomas

• hearing loss that usually affects one ear - you may notice you have difficulty hearing on the phone and in crowded places

• ringing and buzzing sounds in your ear (tinnitus)

• dizziness

• headaches

• feeling that you have lost your balance

Schwannomas in other parts of the body

Schwannomas may involve other nerves in the head. Including the nerves that control movement and feeling in the face and the nerves that control swallowing.  

Schwannomas can also develop in the spinal nerves and in the nerves that are outside the brain and spine (peripheral nerves). 

Symptoms of schwannomas

Some people do not have symptoms from their schwannomas. But you may notice a lump or have pain. Other symptoms include:

• general aching

• burning sensation

• shooting pains

• feeling weak

• pins and needles or a tingling sensation

• numbness

Tests to diagnose schwannoma

Your specialist will examine you and you may need some tests. You usually have an MRI scan . 

You might also have:

• an ultrasound scan - often for schwannomas that are just under the surface of the skin

• a CT scan

• hearing test

You might have a biopsy or surgery to remove the whole tumour to diagnose a schwannoma. A pathologist looks at the tissue under a microscope.  

Your specialist will let you know about other tests you may need.

We have information on some of these tests in our tests and scans page.

Treatment

Treatment depends on where the tumour is in your body and your symptoms. Your specialist may monitor you carefully at first rather than suggest treatment. They will see you regularly and check any symptoms you have. They will examine you at each appointment and you may have some tests. 

Surgery

The main treatment for schwannoma is surgery to remove the tumour. The type of surgery you have depends on where in the body the tumour is.

Targeted radiotherapy

You may have stereotactic radiotherapy or radiosurgery. Both treatments target high doses of radiotherapy to the tumour.

You will also have treatment to control any pain you have. You might see a doctor who specialises in pain control.

Your specialist will explain the treatment to you and tell you about the possible side effects. 

NF2-related Schwannomatosis and non NF2-related Schwannomatosis

Adults or children with multiple schwannomas and children who have a single schwannoma may have tests to see whether they have one of the rare genetic conditions:

• NF2-related Schwannomatosis or 

• schwannomatosis - (non NF2-related)

NF2-related schwannomatosis

This is a rare condition. It is also known as Neurofibromatosis Type 2. It is caused by a faulty gene . This fault causes the cells to divide uncontrollably. People with this condition usually develop symptoms when they are teenagers or young adults. But sometimes symptoms start earlier in childhood.

In NF2-related schwannomatosis you are more likely to develop:

• symptoms of vestibular schwannomas in both ears

• other nerve schwannomas in the brain. For example, in the nerves supplying movement and feeling to the face and nerves that control swallowing

• schwannomas in the spine

• schwannomas on or under the skin

• eye problems such as cataracts (cloudy patches on the lens)

Symptoms include:

• hearing loss - this may affect one or both ears

• ringing and buzzing in the ears (tinnitus)

• blurred vision

• lumps that develop under the skin

• pins and needles

• numbness

• a burning feeling

• weakness in your muscles

The treatment you have may include:

• regular check-up appointments with tests - these may include, MRI scans hearing tests and eye tests

• surgery

• targeted radiotherapy

• pain control

Children with symptoms often have problems with their eyes, and hearing and can also have pain. 

The tests you might have are the same as those listed on this page. But also include eye tests and blood tests for genetic testing. In this blood test, doctors are looking for a change in the NF2 gene.

It is rare for NF2-related schwannomatosis to develop into a cancer. 

As this is a rare condition you may be seen at a specialist center.

This condition can increase your risk of developing a tumor in the lining of the brain and spinal cord, called a meningioma.

Non NF2-related schwannomatosis

This rare condition is also known as schwannomatosis. Non cancerous schwannomas form on the nerve sheath. In particular on the spinal nerves and the nerves around the body. The symptoms are similar to NF2-related Schwannomatosis. But the conditions are different genetically.

Symptoms 

The main symptom is pain. You might also have a lump that may be painful. Other symptoms include numbness, weakness, and a tingling feeling (pins and needles). Symptoms usually start in early adulthood but can develop in younger people.

Some people have symptoms, but no genetic change is seen. So far, two genes have been found:

• LZTR1
• SMARCB1

Doctors think other genes will be identified in the future. 

About 10 in 100 people (about 10%) with genetic changes in LZTR1 develop vestibular schwannomas on one side. As well as developing schwannomas in other parts of the body.

People with SMARCB1 related schwannomatosis may develop meningiomas as well as schwannomas.

Treatment

Controlling the pain is very important in this condition. Removing the schwannoma by surgery can also help relieve the pain. 

Coping

Coping with a diagnosis of a rare condition can be especially difficult. Knowing more about your condition and its treatment can make it easier. It can help you to make decisions and cope with what happens. Speak to your doctor and nurse, they can let you know of any support group that may help you. 

You can also contact Nerve Tumours UK. Nerve  They provide support for people affected by nerve tumors.