Neurofibroma medical therapy: Difference between revisions
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Removal of plexiform neurofibromas is difficult because they can be large and cross tissue boundaries. However, besides pain, plexiform neurofibromas are sometimes removed due to the possibility of [[malignant transformation]]. | Removal of plexiform neurofibromas is difficult because they can be large and cross tissue boundaries. However, besides pain, plexiform neurofibromas are sometimes removed due to the possibility of [[malignant transformation]]. | ||
====Radiation==== | ====Radiation==== | ||
Revision as of 18:48, 16 November 2015
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Neurofibroma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Neurofibroma medical therapy On the Web |
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American Roentgen Ray Society Images of Neurofibroma medical therapy |
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Risk calculators and risk factors for Neurofibroma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]
Overview
Treatment
Dermal neurofibroma
Dermal neurofibromas are not usually surgically removed unless they are painful or disfiguring, because there are generally so many of them and they are not dangerous.
CO2 lasers have been used to remove dermal neurofibromas. In a paper titled Hypertrophic Scars After Therapy with CO2 Laser for Treatment of Multiple Cutaneous Neurofibromas Ostertag et al. said this about treatment by laser: “The cosmetic disfigurement is the most important issue in the decision to treat cutaneous symptoms of neurofibromatosis. Treating patients with extensive neurofibromas with [a] CO2 laser is still the best choice. However, it is strongly advised that a test treatment be performed to judge the effectiveness of the procedure and whether the developed scar is an acceptable trade-off.” [1]
Plexiform neurofibroma
Surgery
As of 2002, the primary treatment option for plexiform neurofibroma was surgery.[2]
Removal of plexiform neurofibromas is difficult because they can be large and cross tissue boundaries. However, besides pain, plexiform neurofibromas are sometimes removed due to the possibility of malignant transformation.
Radiation
Once a plexiform neurofibroma has undergone malignant transformation, radiation and chemotherapy can be used as treatment. However, radiation is generally not used as a treatment for plexiform neurofibromas because of concerns that this could actually promote malignant transformation. There has even been a documented case of a Schwannoma being induced from a neurofibroma due to radiation therapy.[3]
Medications
ACE inhibitors have been proposed as a novel treatment of neurofibromas. ACE inhibitors are currently used to treat hypertension and congestive heart failure, to avert remodeling and reinfarction after myocardial infarction, and to ameliorate diabetic nephropathy and other renal diseases. ACE inhibitors work by indirectly down regulating TGF-beta, which is a growth factor that has been shown to influence the development of tumors.[4]
References
- ↑ Ostertag JU, Theunissen CC, Neumann HA. (2002). "Hypertrophic scars after therapy with CO2 laser for treatment of multiple cutaneous neurofibromas". Clinical Orthopaedics and Related Research. 28 (3): 296–8. doi:10.1046/j.1524-4725.2002.01145.x. PMID 11896787.
- ↑ Packer RJ, Gutmann DH, Rubenstein A, et al. (May 2002). "Plexiform neurofibromas in NF1: toward biologic-based therapy". Neurology. 58 (10): 1461–70. doi:10.1212/wnl.58.10.1461. PMID 12041525.
- ↑ Isler MH, Fogaça MF, Mankin HJ. (1996). "Radiation induced malignant schwannoma arising in a neurofibroma". Clinical Orthopaedics and Related Research. 325 (325): 251–5. doi:10.1097/00003086-199604000-00031. PMID 8998885.
- ↑ Namazi H. (2008). "ACE inhibitors: a novel treatment for neurofibroma". Clinical Orthopaedics and Related Research. 15 (5): 1538–9. doi:10.1245/s10434-007-9737-5. PMID 18157575.