Background: Almost 60% of all spinal tumors are spinal intradural extramedullary (IDEM) neoplasms. The most common symptoms of these tumors are pain and neurological deficits. Until recently, the treatment of choice is still tumor resection microsurgically. The study aims to present of diagnosis and management of IDEM in Hasan Sadikin Hospital, Bandung, Indonesia, and to outline the current diagnosis and management of IDEM tumors commonly performed. Methods: This study was a retrospective descriptive study using medical records to identify and describe cases of IDEM tumors in Hasan Sadikin Hospital. A total of seven IDEM tumor cases from January 2019 to April 2021 were identified. Data collected included demographics, diagnosis, and management. Results: Most cases of IDEM tumors in our study were seen in women >40 years of age (n = 5). The age range of patients at diagnosis is between 25 and 68 years. The management carried out is tumor resection through laminectomy with (n = 5) or without (n = 2) posterior stabilization. Conclusion: The proper diagnosis and treatment are required in improving a patient’s life quality. Magnetic resonance imaging is the gold standard for radiological examination, and for management of choice is gross-total removal of the tumor.

Schwannoma is a tumor that comes from neural crest-derived Schwann cells. It comprises about 25%–30% of all spinal tumors. Giant invasive schwannoma of the spine is a neoplasm that extends in two or more levels of vertebrae, makes an erosion of vertebral bodies, and extends also into the extraspinal space. We report a case of giant invasive lumbosacral spinal schwannoma, clinical pictures, surgical procedures, and outcomes. A 25-year-old female came to our hospital with weakness of both lower extremities with progressive pin-and-needle sensation in both legs, followed by numbness that gets worsened for the past 2 years ago. Physical examination revealed paresthesia at dermatome L4, L5, S1 on both sides and physiological reflexes diminished on both sides. Motor examination showed decreasing activities of knee extension, ankle dorsiflexion, great toe extension, and ankle plantar flexion on both sides. Contrast lumbosacral magnetic resonance imaging showed hypointense and hyperintense lesion at L2–L3–L5–S1 extending to corpus L4 that enhanced with contrast administration on T1- and T2-weighted image. Myelogram showed obliteration of subarachnoid cerebro-spinal fluid (CSF) space. The patient underwent tumor resection and posterior stabilization. 90% of the tumor was resected. Good result was achieved after surgery. Surgery is the gold standard for this tumor, the goal of which is decompression of the nerve. Because of extensions of this tumor, careful preoperative planning and careful resection are very important. Gross total removal should improve neurological deficits. Further follow-up is required.