Schwannoma: Challenging diagnosis

Cox, James M.; Alter, Michael

doi:10.1067/mmt.2001.118203

Cited by 13 publications

(20 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As our case demonstrates, chronic abdominal pain with atypical features should alert the clinician to consider a structural neurological source for the patient's pain. A pain history that is inconsistent with gallbladder-or appendixrelated syndromes, along with radicular features, may be clues to the possibility of a neurological source of the pain (3,4). Our patient's chronic intermittent history made the diagnosis elusive.…”

Section: Discussionmentioning

confidence: 84%

“…Three years after surgical resection he remains pain free. The patient reported by Cox and Alter was a 30-year-old man with an eleven-month history of right flank and abdominal pain (4). An exhaustive workup failed to identify a gastroenterological etiology.…”

Section: Discussionmentioning

confidence: 99%

“…However, patients presenting with chronic undiagnosed abdominal pain can be harboring an intraspinal tumor or other mass as the cause for their symptoms. These lesions can occur in all age groups (2,4,5,6,8,9). The majority are in the thoracic spine and representsapproximately 1% of all neurological tumors (13).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Thoracic meningioma masquerading as chronic abdominal pain

Lyons

Windgassen

Kinney

et al. 2010

Turkish Neurosurgery

View full text Add to dashboard Cite

Chronic abdominal pain without a structural or metabolic gastroenterological etiology can be extremely challenging to diagnose. Patients presenting with an associated radicular pattern of pain may alert the clinician to a possible structural neurological cause of the symptoms. We present the case of a 70-year-old woman who presented to our institution with an 18-month history of right upper quadrant abdominal pain. She had no associated symptoms or provoking factors. She underwent an extensive gastroenterology evaluation, including colonoscopy that was unrevealing. Ultrasound demonstrated gallstones and she was evaluated for cholecystectomy. She subsequently developed right costal margin pain. Her symptoms remained stable over the course of the next year. Follow-up general surgical evaluation was still unconvincing that the gallstones were the etiology of her symptoms. A thoracic spinal MR demonstrated a large intradural extramedullary mass at T8. The patient's neurological exam was normal. She underwent a thoracic laminectomy and resection of meningioma with intraoperative electrophysiological monitoring. Her abdominal pain resolved. Patients can present with months to years of elusive abdominal symptoms only to be eventually found to be harboring an undiagnosed spinal tumor. We discuss the case and review the literature reports of spinal tumors masquerading as chronic abdominal pain. KeywoRds: Thoracic meningioma, Spinal cord, Abdominal pain ÖZYapısal veya metabolik bir gastroenterolojik etiyoloji olmadan kronik abdominal ağrının tanısını koymak çok zor olabilir. İlişkili radiküler ağrı paterniyle gelen hastalar klinisyenin bu yakınmaların olası bir yapısal nörolojik nedeni olabileceği konusunda dikkatli olmasını sağlayabilir. Hastanemize 18 aydır sağ üst kadranda abdominal ağrı öyküsüyle gelen 70 yaşında bir kadın sunulmuştur. Herhangi bir ilişkili belirti veya uyarıcı faktör bulunmamıştır. Kolonoskopi dahil yapılan kapsamlı gantroenteroloji değerlendirmesinde pozitif bir bulgu saptanmamıştır. Ultrason safra taşları göstermiş ve hasta kolesistektomi açısından değerlendirilmiştir. Daha sonra sağ kosta kenarında ağrı gelişmiştir. Belirtileri sonraki yıl boyunca stabil olarak devam etmiştir. Takiplerde yapılan genel cerrahi değerlendirmesi halen belirtilerin nedeninin safra taşları olduğu konusunda inandırıcı bulunmamıştır. Yapılan torasik spinal MR T8 seviyesinde büyük bir intradural ekstramedüller kitle göstermiştir. Hastanın nörolojik muayenesi normaldir. İntraoperatif elektrofizyolojik izlemeyle birlikte torasik laminektomi ve menenjiyom rezeksiyonu yapılmıştır. Abdominal ağrı kaybolmuştur. Hastalar aylar veya yıllar süren şüpheli abdominal belirtilerle başvurup daha sonra tanı konmamış bir spinal tümörleri olduğu saptanabilir. Vakayı sunuyor ve kronik abdominal ağrı görünümü veren spinal tümörlerin literatür raporlarını gözden geçiriyoruz.

show abstract

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Thoracic meningioma masquerading as chronic abdominal pain

Lyons

Windgassen

Kinney

et al. 2010

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…En un interesante artículo, Creagh et al (1) describen un caso de schwannoma maligno, neoplasia que puede manifestarse clíni-camente de modos muy variados (2). Recientemente hemos tenido ocasión de atender a otra paciente con este raro tipo de tumor (3), que se presentó con fiebre prolongada y anemia.…”

unclassified

Fiebre prolongada y schwannoma maligno

Roca

2002

An. Med. Interna (Madrid)

View full text Add to dashboard Cite

69quio principal contiene cartílago siendo más rígida que la de la arteria pulmonar. Además, la arteria pulmonar es un sistema de baja presión, con lo cuál cualquier compresión o distorsión aiterial puede ocasionar una redistribución marcada en el flujo sanjguíneo arteial; b) La hipoxia secundaria a la obstrucción del bronquio principal origina una vasoconstricción refleja arterial resultando en una hipoperfisión o ausencia de la captación del radiotrazador homolateral a la lesión. Es decir, el patrón gammagráfico de P/V en el carcinoma broncogénico de localización hiliar, se caracteiza por defectos de actividad en el estudio de P/V en la mayoría de ocasiones no congnentes en su totalidad y con una mayor preservación de la ventilación pulmonar, pudiendo ocasionar un diagnóstico falso positivo de tromboembolismo pulmonar (3).Es interesante, que tras efectuar un tratamiento quirurgico o radioterápico del carcinoma broncogénico intraluminal la alteración congruente de Pi/, puede transformarse en una anomalía no congruente de P/V, ésto es, se puede corregir la hipoventilación secundaria a la lesión, pero resulta más diflcil normalizar los defectos de perfilsión. Este fenómeno representa la persistencia de una vasoconstriccióíiihipetensión vascular pulmonar mediada por el incremento de poliaminas en el pulmón secundario a la hipoxia (1).De lo mencionado hasta ahora cabe resaltar dos hechos, que este patrón gammagráfico puede originar una estimación irreal del VEMS postoperatorio y que también puede ocasionar un diagnóstico inicial falso positivo de tromboembolismo pulmonar.En definitiva, un diagnóstico diferencial exhaustivo en los pacientes que muestran una disminución global de la perfilsión pulmonar, resulta necesario para facilitar el manejo y evitar la yatrogenia derivada de un tratamiento inadecuado. En un interesante artículo, Creagh et al (1) describen un caso de schwannoma maligno, neoplasia que puede manifestarse clíni-camente de modos muy variados (2). Recientemente hemos tenido ocasión de atender a otra paciente con este raro tipo de tumor (3), que se presentó con fiebre prolongada y anemia.Mujer de 14 años sin antecedentes de interés. Ingresa por tener desde hace dos meses fiebre alta persistente y astenia. A la exploración se observa un estado general conservado, temperatura axilar 39 ºC y palidez de piel y mucosas, mientras que todo lo demás es normal. Los análisis muestran: hemoglobina 8,5 g/dL, volumen corpuscular medio 70 fl, plaquetas 681.000/mm 3 , velocidad de sedimentación globular 120 mm en la primera hora, colesterol 134 mg/dL, hierro 11 mg/dl, fibrinógeno 587 mg/dL, albúmina 2,8 g/dL e IgE 394 U/mL, mientras que son normales el resto de parámetros del hemograma, bioquímica, coagulación, proteinograma, anticuerpos antitisulares, hormonas tiroides, enzima conversora de la angiotensina, marcadores tumorales y análisis bási-co de orina. La ASLO es positiva, mientras que son negativos el resto de estudios microbiológicos, incluyendo cultivos de sangre, esputos, orina, heces y médula ósea, y serolo...

show abstract

“…23 Tumours arising in the cauda equina or around the conus medullaris can become larger than other spinal tumours because of the relative mobility of the roots and the wide diameter of the spinal canal.…”

mentioning

confidence: 99%

Giant Cystic Intradural Schwannoma in the Lumbosacral Region: A Case Report

Jaiswal

Rajasekaran

2008

J Orthop Surg (Hong Kong)

View full text Add to dashboard Cite

We report a case of a giant cystic intradural schwannoma of the lumbosacral region in a 30-year-old man who presented with a 2-year history of non-specific lower back pain. Lateral radiographs demonstrated scalloping of the posterior wall of L5 and the upper sacrum. Magnetic resonance imaging revealed a 12x2.3-cm intradural multi-septated cystic lesion extending from L3 to S2 with predominant hypointense signal on T1-weighted images and a mixed signal on T2-weighted images. There was heterogeneous rim enhancement of the retrosacral portion of lesions following the administration of gadolinium contrast. The tumour was completely excised. Histological investigation confirmed the diagnosis of cystic schwannoma with alternating hypercellular (Antoni A) and hypocellular (Antoni B) areas in a fibrillar background. The patient had complete relief of symptoms and remained

show abstract

Schwannoma: Challenging diagnosis

Cited by 13 publications

References 0 publications

Thoracic meningioma masquerading as chronic abdominal pain

Thoracic meningioma masquerading as chronic abdominal pain

Fiebre prolongada y schwannoma maligno

Giant Cystic Intradural Schwannoma in the Lumbosacral Region: A Case Report

Contact Info

Product

Resources

About