neuromas

Neuromas are benign growths that arise from nerve tissue. The term covers true neoplasms such as schwannomas (neurilemmomas) that originate from Schwann cells, as well as non-neoplastic nerve disorders that cause focal nodules or pain. They can occur in various regions, including the head, neck, and extremities, and may be asymptomatic or painful depending on location and size.

True neuromas include schwannomas; the most clinically important is the vestibular schwannoma (acoustic neuroma), which arises from the vestibulocochlear nerve (CN VIII). These tumors are typically benign, slow-growing, and may cause hearing loss, tinnitus, or balance problems; they are usually treated based on size and symptoms.

Non-neoplastic conditions commonly referred to as neuromas include Morton's neuroma, an entrapment neuropathy of an interdigital nerve in the foot that causes burning and numbness between the toes; and traumatic neuromas, which form after nerve injury as a disorganized growth of nerve fibers and scar tissue.

Diagnosis is clinical and supported by imaging. MRI is the preferred method to evaluate intracranial schwannomas, while ultrasound can aid in assessing known plantar interdigital neuromas. Biopsy is rarely needed except when malignancy is suspected.

Treatment depends on the lesion and symptoms. Vestibular schwannomas may be observed or treated with microsurgical resection or stereotactic radiotherapy. Morton's neuroma is managed with shoe modifications, padding, injections, or surgical nerve decompression or neurectomy if conservative care fails. Prognosis for benign neuromas is generally favorable.