Cervical schwannoma with acute worsening and intratumoral hemorrhage

Abstract

Background: Primary spinal tumors are rare and include schwannomas. In the cervical region, these lesions can cause pain, radiculopathy, and/or myelopathy. Case Description: A 53-year-old male presented with 9 months of chronic neck pain and left upper extremity radiculopathy/myelopathy. The MRI revealed an intradural extramedullary C6-C7 mass left-sided mass with foraminal extension. Following a C5-C7 laminectomy with C5-T2 instrumented fusion, the diagnosis of schwannoma with evidence of recent hemorrhage was confirmed by biopsy. Three weeks postoperatively, the patient was pain free, no longer taking opioids, and neurologically intact. Although the MR 6 months later showed no tumor, the MRI 15 months later documented a recurrent enhancing C6-C7 lesion. The patient elected to be treated with external beam radiotherapy and remained asymptomatic. Conclusion: A 53-year-old underwent resection of a cervical C6-C7 schwannoma with intratumoral hemorrhage. Fifteen months following C5-C7 laminectomy with C5-T2 fusion, the tumor recurred and required external beam radiation therapy.

Review of Cervical Schwannomas: Presentation, Pathogenesis, Management, Complications and Future Directions

“…Radiosurgery is a safe and effective alternative for those who aren't candidates of open surgery, including those with multiple or recurrent lesions, advanced age, or multiple comorbidities [61][62][63][64][65]. In 1995, Hamilton, et al, first demonstrated the use of Stereotactic Radiosurgery (SRS) for the treatment of metastatic spinal lesions in 5 patients who had failed to respond to traditional fractionated radiation therapy [61].…”