Giant Invasive Spinal Schwannoma

Yu, Nam Hun; Lee, Soo Eon; Jahng, Tae-Ahn; Chung, Chun Kee

doi:10.1227/neu.0b013e31824f4f96

Cited by 54 publications

(18 citation statements)

References 25 publications

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“…Giant invasive spinal schwannomas may be encountered most frequently in the cervical spine [16] or lumbosacral and sacral spine [5,6]. In the present review of pediatric cases, the lumbar spine was most commonly affected (two cases), followed by the lumbosacral spine (one case), and thoracic spine (one case).…”

Section: Discussionmentioning

confidence: 81%

“…They extend longitudinally over two or more levels; laterally into the extraspinal space through a widened and eroded foramen; posteriorly thinning the posterior elements of the vertebral column; and anteriorly eroding the vertebral bodies [5,6]. The approach, resectability, and stability of the spine are important preoperative considerations for the surgeon when facing this difficult tumor.…”

Section: Discussionmentioning

confidence: 99%

“…These tumors are heterogenous, with mixed hyperintensity and hypointensity on T2-weighted images corresponding to different cellularities, necrotic degeneration, hemorrhage, and cyst formation [5,18,19]. However, it may still be difficult to differentiate giant schwannomas from malignant peripheral nerve sheath tumors and ganglioneuromas based on imaging alone.…”

Section: Discussionmentioning

confidence: 99%

“…These tumors present as huge masses that extend into the vertebral body and the extraspinal space as reported in case reports and small case series [5-12]. Complete removal of giant invasive spinal schwannomas is technically challenging due to its invasive nature, mass effect, and close proximity to important neurovascular structures [6,13].…”

Section: Introductionmentioning

confidence: 99%

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Giant invasive spinal schwannoma in children: a case report and review of the literature

et al. 2013

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IntroductionGiant invasive spinal schwannoma is defined as a tumor that extends over two or more vertebral levels, erodes vertebral bodies, and extends into the extraspinal space disrupting myofascial planes. Because of its rarity, there have been few published reports describing clinical features and surgical outcomes, especially in the pediatric patient population.Case presentationWe analyzed the medical record, pathologic findings, and radiographic studies of a 14-year-old Hispanic boy who presented to Texas Children’s Hospital with a three-month history of progressive spastic paraparesis. Preoperative computed tomography and magnetic resonance imaging reports showed a large mass lesion centered at the left T7-8 neural foramen with intra- and extraspinal extension, resulting in severe spinal cord compression and vertebral body erosion, and protrusion into the retropleural space and descending aorta. Our patient underwent a single-stage posterior approach for complete resection of the tumor with reconstruction and stabilization of the vertebral column. The pathological examination was consistent with schwannoma. At the six-month follow-up, our patient had resolution of preoperative symptoms and remains neurologically intact without any radiographic evidence of recurrent tumor.ConclusionTo the best of our knowledge, our case represents the fourth child with giant invasive spinal schwannoma reported in the literature. We describe our case and review the literature to discuss the aggregate clinical features, surgical strategies, and operative outcomes for giant invasive spinal schwannoma in the pediatric age group.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Giant invasive spinal schwannoma in children: a case report and review of the literature

et al. 2013

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“…Currently, the standard treatment is gross total resection (GTR) of the tumor with as much preservation of neurovascular structures as possible (7). In 1888, Victor Horsley successfully removed an intraspinal tumor (located at the sixth and seventh thoracic vertebra) for the first time (8).…”

Section: Introductionmentioning

confidence: 99%

Non-Syndromic Spinal Schwannomas: A Novel Classification

Sun

Pamir

2017

Front. Neurol.

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Schwannomas are the most frequent primary tumors of the spine with an incidence of 0.3–0.5/100,000 person per year. Current treatment for non-syndromic spinal schwannomas is total resection of the tumor with preservation of neurovascular structures. This study aims to report neurologic and radiologic outcome following treatment of non-syndromic spinal schwannomas along with a novel tumor classification used in our clinic. A retrospective case series was carried out with a patient sample of 82 male and female patients with non-syndromic spinal schwannomas. All patient data were retrospectively collected from the hospital records. As a routine procedure, after admittance and primary evaluation, patients’ tumors were classified using CT or MRI in accordance with our proposed classification method, which employs a dual designation method with tree groups (A, B, and C) for tumor volume and four types (I, II, III, and IV) for tumor localization. Subsequent resection surgery was followed by neurological assessments and follow up at 45th, 180th, and 360th postoperative day. Along with Karnofsky performance status scale, pain, sensory deficits, and motor weakness were scored to assess neurologic recovery. Our finding indicates that patients with different tumor types significantly differ in their neurological scores and show consistent but differential neurological recovery at early and late time points postsurgery. Complications during and postsurgery were minimal, occurring only in two patients. Our findings further reinforce the established safety of total resection operations and indicate that our proposed classification is a simple, effective tool that has proven helpful in preoperative planning and avoiding unnecessary surgical approaches.

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