Nerve root schwannoma, need biopsy? SRS vs FSRT

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radoncsmile

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Are paraspinal nerve root schwannomas diagnosed radiographically like acoustic schwannomas or is biopsy or FNA standard for diagnosis? What is the risk of nerve damage? Is SRS preferred treatment over conventionally fractionated radiotherapy to 50.4 Gy?

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Are paraspinal nerve root schwannomas diagnosed radiographically like acoustic schwannomas or is biopsy or FNA standard for diagnosis? What is the risk of nerve damage? Is SRS preferred treatment over conventionally fractionated radiotherapy to 50.4 Gy?

I would ask neurosurgeon for biopsy. If (really when) they say no, then I would treat empirically. I would conventionally fractionate if patient is agreeable. If not, hypofrac.
 
My radiologists often say that with a good MRI you can distinguish well between schwannomas and anything else. So, no, we don't do biopsies for those.
When they are removed surgically, the surgeons do it without a frozen section.
 
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