Risk factors for recurrence and regrowth of spinal schwannoma

Takahashi, Takuri; Hirai, Takashi; Yoshii, Toshitaka; Inose, Hiroyuki; Yuasa, Masato; Matsukura, Yu; Morishita, Shingo; Kobayashi, Yutaka; Utagawa, Kurando; Kawabata, Atsuyuki; Hashimoto, Jun; Tanaka, Tomoyuki; Motoyoshi, Takayuki; Hashimoto, Motonori; Kawabata, Shigenori; Okawa, Atsushi

doi:10.1016/j.jos.2022.03.003

Cited by 11 publications

(6 citation statements)

References 18 publications

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“…Fehlings et al. reported that tumor size and tumor involving additional levels were the key predictors of tumor recurrence ( 15 ), which had been validated in a recent study ( 22 ). In line with these results, our study showed a significant trend of tumor recurrence in patients with tumors involving > 2 vertebral segments.…”

Section: Discussionmentioning

confidence: 95%

Scoring model to predict postoperative neurological deterioration in spinal schwannoma

Liu

Xu²,

Shen³

et al. 2023

Front. Oncol.

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BackgroundSpinal schwannomas (SSs) are benign tumors affecting the nerve sheath, accounting for 25% of spinal nerve root tumors. Surgery represents the mainstay of treatment for SS patients. Following surgery, approximately 30% of patients experienced developed new or worsening neurological deterioration, which probably represented an inevitable complication of nerve sheath tumor surgery. The objective of this study was to identify the rates of new or worsening neurological deterioration in our center and accurately predict the neurological outcomes of patients with SS by developing a new scoring model.MethodsA total of 203 patients were retrospectively enrolled at our center. Risk factors associated with postoperative neurological deterioration were identified by multivariate logistic regression analysis. β–coefficients for independent risk factors were used to define a numerical score to generate a scoring model. The validation cohort at our center was used to verify the accuracy and reliability of the scoring model. Receiver operating characteristic (ROC) curve analysis was used to evaluate the performance of the scoring model.ResultsIn this study, five measured variables were selected for the scoring model: duration of preoperative symptoms (1 point), radiating pain (2 points), tumor size (2 points), tumor site (1 point), and dumbbell tumor (1 point). The scoring model divided the spinal schwannoma patients into three categories: low risk (0-2 points), intermediate risk (3-5 points), and high risk (6-7 points), with predicted risks of neurological deterioration of 8.7%, 36%, and 87.5%, respectively. And the validation cohort confirmed the model with the predicted risks of 8.6%, 46.4%, and 66.6%, respectively.ConclusionThe new scoring model might intuitively and individually predict the risk of neurological deterioration and may aid individualized treatment decision-making for SS patients.

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Section: Discussionmentioning

confidence: 95%

Scoring model to predict postoperative neurological deterioration in spinal schwannoma

Liu

Xu²,

Shen³

et al. 2023

Front. Oncol.

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“…Risk factors for recurrence include subtotal intralesional resection, younger age, and large size. [5,10] e likely cause of recurrence in this patient is the history of NF2 and subtotal resection at the initial surgery due to the clavicle obstructing the surgeon's view. e clavicle is a bone that allows for a full shoulder range of motion while protecting the BP and large vascular structures such as the subclavian artery and vein.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for recurrence include subtotal intralesional resection, younger age, and large size. [ 5 , 10 ] The likely cause of recurrence in this patient is the history of NF2 and subtotal resection at the initial surgery due to the clavicle obstructing the surgeon’s view.…”

Section: Discussionmentioning

confidence: 99%

Clavicular window for brachial plexus schwannoma removal

Carbullido,

Page,

Hanna

2024

Surgical Neurology International

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Background: Schwannomas are benign nerve sheath tumors that can either be sporadic or part of neurofibromatosis type 2 (NF2). Tumors of the brachial plexus (BP) with both supra- and infraclavicular components are uncommon and represent a challenge to complete surgical resection. There are few reports on single clavicular osteotomies for BP exposure; however, there are currently no reports of utilization of a clavicular window for a large schwannoma resection. Case Description: We report a case of a patient with a schwannoma spanning the BP roots to the cords, with the majority involving the retro clavicular inferior trunk in the setting of NF2. The patient underwent previous subtotal resection and had postoperative enlargement of the residual mass. A gross total resection was made possible by the creation of a clavicular window to expose the BP. A 2 cm segment piece of the mid-clavicle was removed, allowing for roughly 6 cm of mediolateral exposure through clavicular distraction. This clavicular window facilitated complete exposure of the BP schwannoma underneath the clavicle as well as unobstructed exposure of supraclavicular and infraclavicular tumor. The segment was then refixed with a plate after resection of the tumor. Conclusion: The use of a clavicular window allowed for extensive exposure of the trunks and divisions of the BP to achieve a gross total resection in this case. The clavicular window approach may provide a benefit for optimizing exposure in the setting of lesions involving the trunks and divisions that the clavicle would traditionally obstruct.

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“…Notably, only 10 cases with aggressive intraosseous schwannoma in the lumbar spine have been reported to date (Table 1) 3) . Although spinal nerve sheath schwannoma often grows into the spinal canal and intervertebral foramen 4) , thereby forming a dumbbell tumor usually with sclerotic and clear margins 5) , aggressive intraosseous schwannoma can lead to invasive and osteolytic bone destruction in the vertebrae. Therefore, it is important in terms of radiological evaluation to understand the difficulty in differentiating between malignant tumors and osteolytic lesions caused by aggressive intraosseous schwannoma 6) .…”

Section: Intraosseous Aggressive Schwannoma In the Lumbar Spine: A Ca...mentioning

confidence: 99%