17877 Schwannoma

Overview

A schwannoma is a usually non-cancerous (benign) tumor that grows from Schwann cells, the cells that form the protective covering around nerves. It can develop anywhere in the body, most often on the nerves that control hearing and balance or along the spine. Most schwannomas grow slowly and do not spread.

Schwannomas are uncommon. Vestibular schwannomas (also called acoustic neuromas) are the most frequent type, with about 1 in every 100,000 people diagnosed each year.

Schwannomas can happen at any age, but they are most often found in adults between 30 and 60. They affect men and women equally. Some genetic conditions can make them more likely.

Symptoms

Common symptoms

• A painless lump under the skin
• Tingling, numbness, or weakness in an arm or leg
• Hearing loss, ringing in the ear, or balance problems (if the tumor presses on the hearing/balance nerve)
• Pain in the area of the nerve
• Problems with balance or clumsiness

Symptoms in children

• Schwannomas are rare in children. When they happen, symptoms may include a growing lump, pain, or nerve-related symptoms like weakness or numbness. Children with certain genetic conditions may develop multiple schwannomas.

Symptoms in older adults

• In older adults, symptoms may be easier to miss because they can be confused with age-related changes, such as hearing loss or balance issues. Any new or persistent numbness, weakness, or pain should be checked by a doctor.

Causes

Main causes

• The exact cause of most schwannomas is not known. They begin when Schwann cells grow out of control for no clear reason.
• A small number of cases are linked to inherited conditions, most commonly neurofibromatosis type 2 (NF2).
• Exposure to radiation in the past, especially around the head and neck, is a rare risk factor.

Risk factors

• Having neurofibromatosis type 2 (NF2) or a family history of this condition
• Having had radiation therapy to the head or neck as a child
• Rarely, a family history of schwannomas without NF2

When to see a doctor

See a doctor urgently if:

• See a doctor the same day if you notice sudden weakness, a new lump that is growing quickly, or worsening neurological symptoms. If symptoms are severe or come on suddenly, call your local emergency number.

Book a routine appointment if:

• Make a routine appointment if you have ongoing numbness, tingling, pain, hearing loss, dizziness, or a painless lump that does not go away.
• Also see your doctor if you have balance problems that affect your daily life.

Diagnosis

To diagnose a schwannoma, a doctor will likely ask about your symptoms, examine the area, and test your nerve function. Imaging tests, especially MRI, are the most reliable way to see the tumor. If needed, a small sample of tissue (biopsy) may be taken to confirm the diagnosis.

Tests that may be done

• Magnetic resonance imaging (MRI): creates detailed pictures of the tumor and nearby nerves
• Computed tomography (CT) scan: can show bone changes and outlines the tumor
• Biopsy: a thin needle removes a tiny sample of tumor tissue to examine under a microscope
• Nerve tests (electromyography/nerve conduction studies): check how well your nerves are working

What to expect at your appointment

You will likely be referred to a specialist, such as a neurologist, neurosurgeon, or ear, nose, and throat (ENT) doctor. The specialist will explain the tumor's size and location and talk through your options. You may need to wait for tests, but this is normal.

Treatment

Treatment depends on the tumor's size, location, growth rate, and your symptoms. Options include careful observation (watchful waiting), surgery, or radiation therapy. Some tumors do not need treatment right away, especially if they are small and not causing symptoms.

Self-care at home

• Stay active in ways that feel safe, like walking or swimming, to keep muscles strong and balance steady.
• Use a walking aid if you feel unsteady.
• Ask your doctor about physiotherapy or occupational therapy for balance or weakness.
• Keep a symptom diary to share with your healthcare team.

Medical treatments

There are no medicines that can cure schwannoma. Pain or discomfort can be managed with simple pain relievers you can buy over the counter, but always check with a pharmacist or doctor first before taking any medicine. For tumors that grow or cause symptoms, surgery or radiation therapy may be recommended. The exact approach is personal to you.

When is surgery considered?

Surgery may be recommended if the tumor is pressing on important nerves, causing pain, hearing loss, balance problems, or if it is growing quickly. The goal is to remove the tumor while protecting surrounding nerves. Discuss the risks and benefits with your surgeon.

Living with this condition

Living with a schwannoma often means regular check-ups and imaging scans to watch for changes. Many people stay active and work or study as usual. If you have hearing or balance issues, small adjustments at home and work can help.

Lifestyle tips

• Get enough rest and manage stress with relaxation techniques like deep breathing or mindfulness.
• Protect your hearing if you have hearing loss—use earplugs in noisy places.
• Connect with others who understand your experience through a support group.

Diet and exercise

A balanced diet with plenty of fruits, vegetables, and whole grains helps maintain your overall health. Exercise such as yoga, tai chi, or gentle strength training can improve balance and strength. Always ask your doctor before starting a new exercise program.

Mental health and emotional wellbeing

A diagnosis of any tumor can bring worry or anxiety. It is normal to feel stressed or uncertain. Talk to your doctor about your feelings—they can offer support and connect you with a counsellor or psychologist. If you ever have thoughts of self-harm, please reach out to a crisis helpline or your local emergency number right away.

Prevention

Most schwannomas cannot be prevented because their cause is unknown. If you have a genetic condition that increases your risk, regular check-ups can help find tumors earlier, but they cannot stop them from forming.

Vaccines

There is no vaccine to prevent schwannoma.

Screening programmes

There is no routine screening test for people without symptoms. For people with a family history of neurofibromatosis type 2, regular MRI scans or other surveillance may be recommended by a specialist.

Complications

If left untreated

• Nerve damage that can cause lasting numbness, weakness, or hearing loss
• Balance and coordination problems that raise the risk of falls
• In very rare cases, a benign schwannoma can become cancerous (malignant peripheral nerve sheath tumor)

Long-term outlook

The outlook for most people with schwannoma is very good. These tumors usually grow slowly, and many never cause serious problems. With the right care, most people continue to live full, active lives. If treatment is needed, modern surgery and radiation are safe and effective for many patients.

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