Peripheral Nerve: Neurofibrosarcoma and Rare Tumors
Abhay Varma – Neurosurgery
Linda Austin – Psychiatry
Dr. Linda Austin:
I’m Dr. Linda Austin. I’m
interviewing Dr. Abhay Varma who is Assistant Professor of Neurosurgery here at
MUSC. Dr. Varma, let’s talk, now, if we
could, about malignant or more serious tumors of the peripheral nerves, the
nerves that are out in the arms and legs, away from the spinal cord. What are the names of some of those rare
Dr. Abhay Varma:
The common rare malignant tumor which can afflict peripheral nerves is
what is called neurofibrosarcoma. It’s
very rare compared to the benign tumors that we talked about in a previous
podcast, namely, the neurofibromas and schwannomas, but it is known in certain genetic conditions
to be more common.
Dr. Linda Austin: So, it’s the most common of the rare
tumors? That sounds like, kind of, an
oxymoron. Do you know how common that is
in the population?
Dr. Abhay Varma: It is difficult for me to give a number. But, in certain conditions, like neurofibromatosis,
it is more common than in folks who do not have neurofibromatosis.
Dr. Linda Austin: Is this typically a tumor in children or
adults, or elderly?
Dr. Abhay Varma: It generally develops in patients with neurofibromatosis,
I would say, later in life. I would say,
after the second or third decade.
Dr. Linda Austin: In a patient with neurofibromatosis, where
you have so many tumors anyway, how do you even realize that one of them
happens to be malignant?
Dr. Abhay Varma: If it starts growing rapidly and is
associated with pain, swelling and redness in that area, then the suspicion is,
obviously, that it could a malignant process.
Then, really, it’s our responsibility to make sure that we are not missing
Dr. Linda Austin: So, I’m sure, then, you remove that tumor, is
Dr. Abhay Varma: Yes.
We have to go in for a biopsy and, sometimes, you know, if the tumor has
really spread out, it may even involve sacrificing the limb.
Dr. Linda Austin: And how about radiation or chemotherapy? Are they indicated?
Dr. Abhay Varma: They would be, depending on how much the
tumor has spread. If it has spread
beyond its local confines then it would require adjuvant therapy.
Dr. Linda Austin: Are there any other malignant tumors that you
see from time to time?
Dr. Abhay Varma: It is very unusual to see other kinds of
malignant tumors involving the nerves.
Right now, I can’t think of any others coming from nerves.
Dr. Linda Austin: Well, thank you very much.
Dr. Abhay Varma: You’re welcome.
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