One-stage removal of a giant thoracic paraspinal shamrock-shaped schwannoma via modified hemilaminectomy and posterolateral thoracotomy

Lan, Zhi Gang; Chen, Hai Feng; Huang, Si; Pu, Qiang

doi:10.1016/j.spinee.2012.05.014

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Currently, to excise tumors in the thoracic cavity using the traditional posterior approach for thoracic dumbbell tumors, it is often necessary to make a large incision and remove part of the ribs, transverse processes, and vertebral pedicles, to increase the exposure of the posterolateral structures. This leads to the need for spinal internal fixation to maintain stability of the spine after tumor removal 2,8–10 . Ando et al .…”

Section: Discussionmentioning

confidence: 99%

Efficacy of One‐stage Paravertebral Approach using a Micro‐Tubular Technique in Treating Thoracic Dumbbell Tumors

Wang

Chen

Liang

et al. 2021

Orthopaedic Surgery

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The aim of the present study was to investigate the feasibility and efficacy of one-stage surgical resection of thoracic dumbbell tumors using a paravertebral approach and a micro-tubular technique.Methods: Clinical data of thoracic dumbbell tumors resected using a paravertebral approach and a micro-tubular technique (14 mm, non-expandable type) in the Department of Neurosurgery at our hospital from July 2014 to July 2019 were retrospectively analyzed. Tumors were found between T1 and T12 vertebrae. Operation time, blood loss, hospitalization, recovery of neurological function, complications, the Japanese Orthopaedic Association (JOA) score, and the visual analogue scale (VAS) score were used to evaluate clinical efficacy.Results: In all 31 cases, tumors were completely resected in one operation, with a mean blood loss of 53.23 AE 33.08 mL (20-150 mL) and a mean operation time of 95.16 AE 20.31 min (60-180 min). According to the Eden classification, there were four type II cases, 16 type III cases, and 11 type IV cases. The incidence of tumors in the lower thoracic segment (T8-T12) was 51.6% (16/31 cases), while the incidences in the upper thoracic segment (T1-T4) and middle segment (T5-T8) were 25.8% (8/31 cases) and 22.6% (7/31 cases), respectively. Pathological diagnoses were schwannoma (n = 22), gangliocytoma (n = 4), metastatic tumor (n = 2), neurofibroma (n = 1), granuloma (n = 1), and lipoma (n = 1). After surgery, symptoms were relieved in all patients. VAS and JOA scores significantly improved (P < 0.001). There was no pleural or lung injury, and there were no complications, such as cerebrospinal fluid leakage. The average follow-up duration was 29 months (13-59 months), during which time no tumor recurrence or spinal instability occurred. The group of Eden type II tumors had lower JOA scores at 12 months postoperatively, longer operation times, and more estimated blood loss compared with other groups (P < 0.05). There were no significant influences on VAS scores at 12 months postoperatively and postoperative hospital stay from the different types of tumors. Conclusion:The paravertebral approach with a micro-tubular technique is a safe and effective minimally invasive surgical approach for thoracic dumbbell tumors that allows one-stage tumor resection using a single incision. Using this approach significantly reduces intraoperative blood loss and postoperative complications, shortens hospital stay, and reduces the rates of postoperative spinal instability.

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Section: Discussionmentioning

confidence: 99%

Efficacy of One‐stage Paravertebral Approach using a Micro‐Tubular Technique in Treating Thoracic Dumbbell Tumors

Wang

Chen

Liang

et al. 2021

Orthopaedic Surgery

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“…finely manipulate and inspect the neuroforamen (using a surgical microscope) is a major advantage, which in turn benefits the patient. 5 As the left vagus nerve passed through the tumor mass, we were dealing here with a very rare vagus nerve schwannoma. Only between 4 and 6% of the neurogenic tumors originate in the visceral compartment from the nerve sheaths of the vagus or phrenic nerve.…”

Section: Discussionmentioning

confidence: 99%

“…In such a situation, the surgeon's ability to finely manipulate and inspect the neuroforamen (using a surgical microscope) is a major advantage, which in turn benefits the patient. 5 …”

Section: Discussionmentioning

confidence: 99%

Giant Intrathoracic Left-Sided Vagal Schwannoma

Kirschbaum

Ritz

Pehl

et al. 2013

THORAC CARDIOV SURG Reports

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Extensive intrathoracic tumors are rarely diagnosed radiologically without pre-existing symptoms. If located in the posterior mediastinum, it is most probably a neurogenic tumor. Schwannoma is the most frequent neurogenic neoplasia in this location, and most schwannomas are benign. To specify the diagnosis, a thoracic computed tomography must be done; if the growth is close to the medullary canal, a magnetic resonance tomography of the spinal column is necessary to detect neuroforamen infiltration. Our surgical goal was complete excision of the tumor, although many authors favor a minimally invasive approach. In our patient we performed open, en bloc removal of the tumor; removal of parts of the intraforamen was also necessary, which necessitated revision of the affected neuroforamen. Histologically this was a very rare case of vagal schwannoma (which has an incidence of less than 6% of all neurogenic tumors). This patient has a very promising prognosis following complete tumor resection.

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“…Spinal Schwannomas mostly occur intradurally (>80%), but sometimes extend extradurally through the intervertebral foramina [6] assuming a typical dumb-bell shape [7]. They usually appear as painless, well encapsulated firm tumors arising from a single nerve fascicle and mainly occur in the cervical and lumbar regions [8].…”

Section: Introductionmentioning

confidence: 99%

A Purely Paraspinally Located Schwannoma from a Dorsal Root of a Spinal Nerve

Ohla

Scheiwe²

2014

BJMMR

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Background: Spinal Schwannomas are benign nerve sheet tumors and the most common intradural extramedullary tumors of the spine, mainly occurring in the cervical and lumbar region. Case Description: Here we illustrate the case of a 34-year-old woman with a paraspinal lesion presenting with severe lumbar pain. There were no focal sensory or motor deficits. Magnetic resonance imaging (MRI) disclosed a nodular lesion embedded in the paraspinal lumbar musculature, suspicious of tumorous growth. Complete surgical excision of the lesion was performed with clear margins and neuropathological analysis revealed a Schwannoma. Postoperative imaging confirmed a gross total resection with no recurrence after 6 months. Conclusion: Although Schwannomas are frequently encountered in the lumbar spine, a location distinct from the spinal canal is very rare. To be adequately treated, it needs to be considered in the differential diagnosis of any spinal or paraspinal mass. As with other accessible and symptomatic lesions, the treatment of choice is complete excision with clean margins to avoid local recurrence.

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One-stage removal of a giant thoracic paraspinal shamrock-shaped schwannoma via modified hemilaminectomy and posterolateral thoracotomy

Cited by 7 publications

References 10 publications

Efficacy of One‐stage Paravertebral Approach using a Micro‐Tubular Technique in Treating Thoracic Dumbbell Tumors

Efficacy of One‐stage Paravertebral Approach using a Micro‐Tubular Technique in Treating Thoracic Dumbbell Tumors

Giant Intrathoracic Left-Sided Vagal Schwannoma

A Purely Paraspinally Located Schwannoma from a Dorsal Root of a Spinal Nerve

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