Schwannoma on the Sciatic Nerve Root

[Kendra]

I just had an MRI that indicated "enhancement of the LEFT L5 nerve root-sheath through the foramen and external to the canal, possible a schwannoma-neurofibroma." So I've been referred to a neurosurgeon for next steps.  My questions for this group are:

1- Has anyone experienced the tumor on the nerve root and not on the spinal cord?

2 - If yes, what was your experience with the process? Did you have surgery? If yes, what was the outcome?

3 - Any advise you can give?

I see most people of this board have spinal cord schwannomas and I am having a hard time finding information on nerve root tumors outside of the spinal cord/column. My symptoms right now are pretty annoying. I have constant numbness on the outside of my ankle and burn and/or stabbing pains along the top of my foot and sometimes between my toes.

Any advise would be very very appreciated!

Thanks,

Kjohn

[leofwen]

Hi KJohn

I had L5 schwannoma, dumbell, within the canal and within the foramen. I had surgery last year to remove the tumour as pain was excrutiating in my foot and back. Unfortunately the tmour has regrown as they did not take it away for fear of a csf leak. I have the symptoms you describe in my foot. It is really distracting and can get really painful. I also feel like my foot is dropping, especially climbing stairs.

If you look online for foraminal nerve sheath tumours you should find some info. To be honest i think the symtoms will be the same as they relate to the dermatones affected. The removal is where the differences may lie.

Good luck

[HMC]

I am also trying to decide what type of treatment to go with. I have a schwannoma @l5s1. My Neurosurgeon has sent me to a Radio oncologist for a consult to have SRS (type of radiation) therapy to kill this tumor.
Has anyone else been offered this route of treatment?

[terry]

Hi KJohn and Kendra,

Since I have not had treatment for the lesion detected at L2 on my spine [described as a possible schwannoma] I am somewhat in the same boat as you both are.  My tumor is also on the nerve root, this is the description:  "Again seen is an elongated somewhat fusiform multilobulated mass expanding the RIGHT L2-3 neural foramen and extending inferiorly along the expected course of the extra-foraminal nerve in the RIGHT psoas muscle".  Although I am [now] pretty sure that this tumor was causing pain radiating down my right thigh, the Kaiser physician probably assumed the pain was due to degenerative disc disease.  This is important because any tumor that is causing pain falls into a different category [requires a closer look / not just a wait see approach] than a tumor that is just sitting there and not growing.  The decision was made to monitor the tumor. At a 6 month interval, they did another MRI and basically declared that the tumor was not significantly different [if interested, see my post right before your post].   But when I look at the fact that this tumor more than doubled in length in 6 months, I wonder if this is a Schwannoma at all.  I think that the neurologist just looked at the radiologist conclusion and went:  OK, no change. 

Here's my non-expert opinion on some of your questions:
Treatment:  My neurologist is now considering Gamma Knife "Surgery" [really, this is radiation].  Although this is considered non-invasive, any radiation [especially right along the spine] is going to have side effects.  On the UP side this treatment does not require that they cut into your back, through all the bone and muscles.  It is also very precise, so hopefully they can just irradiate the tumor. It is likely that [unlike a real spine surgery], I could simply get up and go home.  That is very attractive.   However, on the DOWN side:  it can NOT remove the bulk of the tumor.  This means that unless it shrinks over time [because it "dies"] it will  continue to put pressure on the nerve root.  It is also possible that this radiation that the tumor might swell in size.  Also, on the down side, they will never be able to biopsy the tumor and determine what kind of tumor it actually is.

I could be wrong on this but it appears that the predominant recommendation for a spinal tumor that need to be removed IS surgery.  However, if they do the surgery, they may also have to fuse a part of your spine. I think my NS may be recommending  Gamma Knife not only because it would be very difficult to get to my tumor but also probably because it is a much less expensive procedure than surgery [and I belong to a "managed health care plan"].  

 

[Dale]

I started having a painful catch in my right buttoch in September it progressed all the way down my right leg by Dec, my GP sent me to rehab which almost killed me. I went one time. Finally got an mri late December and I had a schwannoma tumor 15x18x10. Pain was beyond anything I have ever experienced could not sit on a toilet, get in bed,or sit period without screaming.forget radiation and just have the surgery (you will not know if it's cancer till they get in there).mine had already grown into my spinal cord, I had the surgery in January, only two days in hospital with 6 weeks of no bending, lifting or twisting. Good luck and God speed.

[Dale]

I forgot to mention the tumor was on the L3, and my they cut the vertebrae and put it back with a very small disk and 2 tiny screws.

[Lisa P]

I'm curious how the original poster ended up faring. Did you have surgery or go for a different option? I was dx with a schwannoma on the L5 nerve root a couple months back and due to the possibility of a foot drop, my neurosurgeon wants me to "exhaust all non-invasive options" before we talk surgery. Unfortunately pain management isn't working and I'm at a pain level of 8 on a daily basis. I'm only 31, have 2 small kids, and am extremely healthy and active, aside from this dang tumor. I am extremely stressed about what to do and would love to hear treatment routes others with nerve root schwannomas took.