Mobile Schwannoma of the Cauda Equina Diagnosed by Magnetic Resonance Imaging and Magnetic Resonance Myelography: A Case Report and Review of the Literatures

Lee, Dong Yeob; Chung, Hun Jae

doi:10.21129/nerve.2017.3.2.71

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…Intraoperative myelography, ultrasonography, and MRI have been used to determine the mobility of schwannoma [ 9 , 13 ]. Notwithstanding, each method has its own set of issues.…”

Section: Discussionmentioning

confidence: 99%

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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“…Intraoperative myelography, ultrasonography, and MRI have been used to determine the mobility of schwannoma [ 9 , 13 ]. Notwithstanding, each method has its own set of issues.…”

Section: Discussionmentioning

confidence: 99%

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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“…The literature showed 28 cases of migrating spinal intradural masses that were predominantly schwannomas, followed by ependymomas and neurenteric cysts. [ 2 3 4 6 ] In 1991, Murai et al . reported a thoracolumbar neurenteric cyst that had migrated eight levels.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] Other studies described a total of 10 migrating spinal cord schwannomas involving different levels. [ 3 6 ] Notably, however, no cases of migrating intradural spinal masses/schwannomas were associated with adjacent level intervertebral disc herniations.…”

Section: Discussionmentioning

confidence: 99%

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Migrating spinal intradural schwannoma with adjacent disc herniation: A case report and brief literature review

Ghalaenovi¹,

Fattahi²

2018

Surg Neurol Int

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Background:Schwannoma is the most common migrating tumor in the intradural space.Case Description:We present a patient with migrating schwannoma of the cauda which admitted with buttock and thigh pain since 2 years ago. On two preoperative lumbosacral magnetic resonance imaging (MRI), he had a L2/3 disc herniation concomitant with the intradural extra-axial mass at level of the L1/2 disc on the first MRI and then on the second one, his mass was just posterior to the L3 vertebral body, 22 months later. During the surgical resection of the mass, we found it just posterior to the L2 body. In the literature, we found no accompaniment of migrating intradural spinal mass with adjacent intervertebral disc herniation caused by a double-level cerebro-spinal fluid (CSF) blockade, as it was with our case. On serial imaging, we have seen the mass above and then below the level of CSF blockade, resulting from an extra-dural disc herniation.Conclusion:We think this rare case could promote a better understanding of the dynamic nature of the central nervous system and the peripheral nervous system within intradural space.

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“…Leírtak úgynevezett mobilis intraduralis extramedullaris schwannomákat is, az irodalomban mindössze 24 ilyen esetről számoltak be. Az elváltozás mobilitása öszszefüggésbe hozható az intrathecalis nyomás vagy a gerinc testtartásának változásával, pontos mechanizmusát azonban még nem sikerült egyértelműen tisztázni [11].…”

Section: Esetismertetésunclassified

A cauda equina „ancient” típusú schwannomája

Viczei

Patai

Kiszely

et al. 2022

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Összefoglaló. A cauda equina daganatai a leggyakrabban lumbagós panaszokkal jelentkeznek. Általában késői stádiumban ismerik fel őket, mivel lassan növekednek, az anatómiai környezet tágas, a megjelenő tünetek nem specifikusak, valamint az érintett betegek többsége fiatal és egyébként egészséges. Jelen közleményünkben egy ritka variáns, a cauda equinát érintő „ancient” típusú schwannoma esetének kórtörténetét és kezelését mutatjuk be. Műtéti ellátás során a daganat totális eltávolítása történt, ezt követően a beteg panaszai megszűntek. Ezen daganat klinikai kimutatását preoperatív T1-, T2-súlyozott MRI tette lehetővé, a pontos diagnózist azonban az eltávolított daganat patológiai szövettani feldolgozása biztosította. Irodalmi áttekintésünk alapján a cauda equinában ez a szövettani altípusú schwannoma kifejezetten ritka: nemzetközi szinten 3 ilyen publikált eset jelent meg, magyar nyelvű közlést a témában azonban nem találtunk. Orv Hetil. 2022; 163(5): 195–200. Summary. Tumors of the cauda equina generally present with lower back pain. They are usually recognized at a late stage as they grow slowly, the surrounding anatomical environment is spacious, the symptoms that appear are not specific, and the majority of the affected patients are young and otherwise healthy. In this paper, we present the diagnosis and treatment of a young male patient who has undergone the surgical removal of an ancient schwannoma of the cauda equina. During the operation, the tumor was completely resected, and following that the patient’s complaints disappeared. The key point to an accurate diagnosis of this kind of tumor before the operation was the appropriate radiological study, i.e., T1-, T2-weighted MRI, and postoperatively the histological processing of the removed neoplasm. Reviewing the literature, this pathological type of schwannoma appeared to be extremely rare in the cauda equina: so far, only three cases have been published internationally, however, we could not find a single paper in the Hungarian medical literature on this topic. Orv Hetil. 2022; 163(5): 195–200.

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Mobile Schwannoma of the Cauda Equina Diagnosed by Magnetic Resonance Imaging and Magnetic Resonance Myelography: A Case Report and Review of the Literatures

Cited by 8 publications

References 13 publications

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

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

Migrating spinal intradural schwannoma with adjacent disc herniation: A case report and brief literature review

A cauda equina „ancient” típusú schwannomája

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