Acute Neurologic Deterioration in Mobile Spinal Schwannoma

Sarıkaya, Caner; Varol, Eyüp; Çakici, Yunus Emre; Naderi, Sait

doi:10.1016/j.wneu.2020.10.142

Cited by 7 publications

(13 citation statements)

References 18 publications

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“…[2] In 1974, Tomimatsu reported the first case of an intradural-mobile schwannoma, and since then, 29 cases have been reported (Table 1). [3–25] In this case, there were 25 males and 5 females with an average age of (49.62 ± 13.88) years, and 1 case with no reported age and gender. The most common location of the lesion was in the lumbar region (60%), followed by the thoracic region (17%), the thoracolumbar junction (13%), the cervicothoracic junction (7%), and the cervical region (3%).…”

Section: Discussionmentioning

confidence: 88%

“…[4,6,9] Several hypotheses have been proposed to explain the reasons for intradural tumor migration, and literature reports have observed redundancy of the cauda equina during myelography. [5,10,14,23,24] In most cases, there are no attachments within the dura mater, and the only restriction for the tumor is the roots connecting the 2 ends. [14] Since there is no spinal cord in the lumbar region, the nerve roots can float in the cerebrospinal fluid, and tumors attached to the redundant cauda equina can have greater mobility.…”

Section: Discussionmentioning

confidence: 99%

“…When the surgeon does not find the tumor at the site of the dural opening, the possibility of lesion migration should be considered. Tomimatsu et al, 1974 [3] 1 47 M C4-C6 C2-C4 2 Rostral Hollin et al, 1978 [4] 1 56 W L1 L4/L5 3.5 Caudal Pau, et al, 1982 [5] 1 50 W L2 L3 1 Repeated movement Tavy et al, 1987 [6] 1 45 M L2 L3/4 1.5 Caudal Isu et al, 1989 [7] 3 51 W T11/T12 T12/L1 1 Caudal 42 M T12/L1 L1/L2 1 Caudal 52 M L1/L2 L2 0.5 Caudal Satoh et al, 1991 [8] 1 66 M L1 T12 1 Rostral Namura et al, 1993 [9] 1 51 M T1/T5 T6/T10 5 Caudal Varughese et al, 1997 [10] 2 65 M L5 L3 2 Rostral 78 M L2/3 L1 1.5 Repeated movement Iizuka et al, 1998 [11] 1 48 M C7/T1 T1/T2 1 Caudal Friedman et al, 2000 [12] 1 28 M L4 L3 1 Rostral Marin-Sanabria et al, 2007 [13] 2 27 M L1 L2 1 Caudal 41 M L2/L3 L1/L2 1 Rostral Kim et al, 2010 [14] 3 [15] 1 L4 L3 1 Rostral Sasaki et al, 2011 [16] 1 56 M L4/L5 L3/L4 1 Rostral Khan et al, 2012 [17] 1 52 M T11/T12 T6/T7 5 Repeated movement Terada et al, 2016 [18] 1 68 M C5/C7 C6/T1 1 Repeated movement Toscano et al, 2016 [19] 1 40 M T11/T12 T12/L1 1 Caudal Kothari et al, 2017 [20] 1 70 M L2/L3 L3/L4 1 Caudal Onishi et al, 2018 [21] 1 49 M L3 L4/L5 1.5 Caudal Shunjie Jia et al, 2019 [22] 1 64 W T5/T6 T3/T4 2 Rostral Hamabe et al, 2019 [23] 1 48 W L4/S1 L2/L4 2 Rostral Sarikaya et al, 2020 [24] 1 68 M L3 L2/L3 0.5 Rostral Honda et al, 2020 [25] 1 25 M T10/T11 T10/T11…”

Section: Discussionmentioning

confidence: 99%

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Mobile schwannoma of the lumbar spine: A case report and literature review

Song,

Li,

Lyu

et al. 2023

Medicine

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Background: Schwannoma is a benign tumor that originates from the cells of nerve sheaths. The occurrence of mobile schwannoma of the lumbar spine is extremely rare, and when clinicians perform spinal explorations in the expected locations, the results are often negative. This report presents a case of mobile schwannoma in the lumbar spine, aiming to remind doctors to consider the possibility of tumor migration during preoperative planning, thereby avoiding secondary harm to the patient. Case report: A 48-year-old male patient presented with a 2-year history of lower back pain and numbness in both lower extremities, which has progressively worsened over the past 3 months. An Magnetic resonance imaging scan revealed an oval-shaped lesion located in the L2/3 vertebral segment, which migrated to the L3/4 vertebral segment following contrast enhancement. The patient underwent tumor resection surgery, and the diagnosis of schwannoma was confirmed through pathological examination. Conclusion: Clinical physicians should increase their understanding of mobile schwannoma of the lumbar spine and utilize imaging techniques to accurately locate the tumor before surgery, in order to avoid unnecessary surgical scope and the risks of additional surgery.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mobile schwannoma of the lumbar spine: A case report and literature review

Song,

Li,

Lyu

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…Several hypotheses have been proposed to explain the reasons for intradural tumor migration, and literature reports have observed redundancy of the cauda equina during myelography [5,10,14,23,24]. In most cases, there are no attachments within the dura mater, and the only restriction for the tumor is the roots connecting the two ends [14].…”

Section: Discussionmentioning

confidence: 99%

“…Hamabe et al ,2019 [23] 1 48 W L4/S1 L2/L4 2 Rostral Sarikaya et al ,2020 [24] 1 68 M L3 L2/L3 0.5 Rostral Honda et al ,2020 [25] 1 25 M T10/T11 T10/T11 10mm Rostral…”

Section: Declarations Ethics Approval and Consent To Participatementioning

confidence: 99%

Mobile Schwannoma of the Lumbar Spine: A Case Report and literature review

Song

Lyu

et al. 2023

Preprint

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Background Schwannoma is a benign tumor that originates from the cells of nerve sheaths. The occurrence of mobile schwannoma of the lumbar spine is extremely rare and has limited documentation in the literature. This report presents a case of mobile schwannoma in the lumbar spine. Case Report A 48-year-old male patient presented with a 2-year history of lower back pain and numbness in both lower extremities, which has progressively worsened over the past 3 months. An MRI scan revealed an oval-shaped lesion located in the L2/3 vertebral segment, which migrated to the L3/4 vertebral segment following contrast enhancement. The patient underwent tumor resection surgery, and the diagnosis of schwannoma was confirmed through pathological examination. Conclusion Clinical physicians should increase their understanding of mobile schwannoma of the lumbar spine and utilize imaging techniques to accurately locate the tumor before surgery, in order to avoid unnecessary surgical scope and the risks of additional surgery.

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Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Khorram,

Watson

2024

Am J Case Rep

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Patient: Male, 62-year-old Final Diagnosis: Mobile spinal schwannoma Symptoms: Difficult urination • lower extremity pain • lower extremity weakness Clinical Procedure: Surgical resection Specialty: Neurosurgery Objective: Rare coexistence of disease or pathology Background: Aside from the rarity of mobile spinal schwannomas, the coexistence of these tumors with herniated intervertebral disc is also scarce. Furthermore, cauda equina syndrome (CES), as a manifestation of intraspinal schwannomas has been reported rarely. Described here is a case of simultaneous lumbar disc bulge and mobile spinal schwannoma presented with intermittent symptoms of CES. Case Report: A 62-year-old man presented with severe but intermittent leg pain for 2 weeks, which later progressed to an episode of lower extremity weakness and difficulty in urination. Magnetic resonance imaging revealed an intraspinal tumor that moved in position relative to the L1–2 disc bulge on scans 6 h apart, with associated spontaneous regression in symptoms. The tumor was found to be a mobile spinal schwannoma, originated from a nerve root. A standard microdissection technique was used to remove the tumor through a spinous process-sparing unilateral approach, with complete laminectomy of L1. Use of intraoperative ultrasound facilitated the accurate tumor localization. Postoperatively, the patient no longer had symptoms. Conclusions: This report presents a combination of a common spinal pathology, intervertebral disc herniation, alongside a rare condition, mobile spinal schwannoma, whose uncommon clinical manifestations, such as CES can cause irreversible neurological deficits. Surgeons need to remain vigilant of potential atypical scenarios when treating patients. Surgical treatment challenges regarding the mobility of tumors, such as accurate localization, should be addressed using intraoperative imaging to avoid wrong-level surgery. To mitigate the irreversible neurological complications, patients should receive comprehensive information for alarming signs of CES.

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Acute Neurologic Deterioration in Mobile Spinal Schwannoma

Cited by 7 publications

References 18 publications

Mobile schwannoma of the lumbar spine: A case report and literature review

Mobile schwannoma of the lumbar spine: A case report and literature review

Mobile Schwannoma of the Lumbar Spine: A Case Report and literature review

Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

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