Spinal Neurinomas. — A comprehensive clinical and statistical study on 47 cases

Salah, S.; Horcajada, Juan Pablo; Perneczky, Axel

doi:10.1055/s-0028-1090433

Cited by 20 publications

(22 citation statements)

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“…Hori et al (8) reported that 71.1% of their 45 spinal neuromas (including seven neurofibromas) originated from sensory roots, 17.8% from the motor roots, and 11.1% from both roots. Most spinal neuromas (which included not only schwannomas but also neurofibromas in some reports) are entirely intradural: 66 to 74% are intradural, 15 to 23% dumbbell (intradural-extradural), and 2 to 15% are extradural (8,15,16,18). Although the cervical (8), thoracic (15), or lumbar predilection of spinal neuromas has been mentioned (18), neuromas of the first two cervical nerve roots are uncommon, accounting for only 5.3% of all spinal neuromas and 18% of cervical neuromas (2).…”

Section: Discussionmentioning

confidence: 99%

“…Most spinal neuromas (which included not only schwannomas but also neurofibromas in some reports) are entirely intradural: 66 to 74% are intradural, 15 to 23% dumbbell (intradural-extradural), and 2 to 15% are extradural (8,15,16,18). Although the cervical (8), thoracic (15), or lumbar predilection of spinal neuromas has been mentioned (18), neuromas of the first two cervical nerve roots are uncommon, accounting for only 5.3% of all spinal neuromas and 18% of cervical neuromas (2). George and Lot (2) reported 44 C2 neuromas (including neurofibromas) in 42 patients with C1 and C2 neuromas, in whom 16 lesions were entirely extradural, 19 were of the dumbbell type, and 7 were strictly intradural.…”

Section: Discussionmentioning

confidence: 99%

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Dumbbell C2 Schwannomas Involving Both Sensory and Motor Rootlets: Report of Two Cases

et al. 2003

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OBJECTIVE AND IMPORTANCE: Intradural-extradural dumbbell C2 schwannomas are rare. This report concerns two such cases with the intradural compartment located ventral to the spinal cord and involving both sensory and motor rootlets. CLINICAL PRESENTATION: One patient was a 57-year-old woman with sensory disturbances in the right extremities and hyperreflexia in the left extremities. The other patient was a 73-year-old man who presented with tetraparesis, walking disability, atrophy of the nuchal and bilateral shoulder muscles, and pain in the right C2 dermatome. INTERVENTION:The extradural component of the tumor was removed first; next, the intradural component was removed successfully via the posterior approach combined with a C1-C2 laminectomy. The patients experienced symptomatic improvement without further deficits except for sensory impairment of the C2 dermatome in one of the patients. CONCLUSION: Intradural-extradural dumbbell C2 schwannomas can be satisfactorily managed with a posterior approach. Removal of the extradural component and opening of the dural ring of the C2 nerve root are necessary for safe extraction of the intradural ventrally located component after debulking. These tumors may arise extradurally within the nerve sheath, extend intradurally and ventrally toward the spinal cord, and involve both sensory and motor rootlets. Spinal schwannomas mostly arise from the intradural sensory root and grow dorsally toward the spinal cord, and occasionally from the motor root to grow ventrally toward the cord. However, intraduralextradural dumbbell C2 schwannomas that are located ventral to the spinal cord and that involve both sensory and motor rootlets have been reported rarely. We present two such cases. CASE REPORTS Patient 1A 57-year-old right-handed woman presented with a 10-year history of occasional difficulty in handwriting and a 7-year history of gradually progressive sensory disturbances in the right hand and lower leg. A preoperative neurological examination revealed dysesthesia in the right hand, hypesthesia and hypalgesia on the lateral side of the right leg, and hyperreflexia in the left upper and lower extremities. Magnetic resonance imaging revealed an intradural-extradural dumbbellshaped mass on the left side, with the intradural component located ventrally at the level of C1-C2 (Fig. 1). A preoperative vertebral angiogram revealed no abnormalities. The tumor was totally removed via a posterior approach with a hockeystick incision and a C1-C2 laminectomy; the left nuchal muscles were reflected laterally by cutting them transversely (Fig. 2). The extradural mass was removed first by resecting the cervical C2 nerve branches distal to the lateral margin of the tumor and then dividing it in the part close to the dura. The result of the intraoperative pathological examination of the cut end of the cervical nerve branches was negative. The dura was then opened longitudinally and an additional T-shaped durotomy was made transversely toward the dural margin at the entrance of the nerve root (d...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Dumbbell C2 Schwannomas Involving Both Sensory and Motor Rootlets: Report of Two Cases

et al. 2003

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“…40) The median age at diagnosis of neurofibroma is similar in patients with NF1 and without NF1, although both groups are younger than patients with spinal schwannomas, whose median age at presentation is in the fifth decade. 32) The sex distribution is equal in all. 23) The rarity of pelvic neurofibroma, even in association with NF1, may be due to the silent nature of these tumors, as there is usually very little neurological deficit.…”

Section: Discussionmentioning

confidence: 99%

Presacral Solitary Giant Neurofibroma Without Neurofibromatosis Type 1 Presenting as Pelvic Mass. Case Report.

Topsakal

Erol

Özercan

et al. 2001

Neurol. Med. Chir.(Tokyo)

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A 35-year-old woman presented with a solitary neurofibroma in an unusual presacral location without neurofibromatosis manifesting as bilateral chronic sciatica for 2 years. She was initially considered as having a giant right ovarian mass, but was referred with a prediagnosis of solitary giant sacral nerve sheath tumor. The initial differential diagnosis was based on neuroimaging. A right-sided J incision with the extraperitoneal approach provided good exposure and handling of the tumor bed. Almost total excision without neurological deficit was possible. The histological diagnosis was neurofibroma. Benign retroperitoneal neural sheath tumors in patients without von Recklinghausen's disease are quite rare. Intrapelvic tumors are often diagnosed at a later stage. Neuroimaging is very helpful to delineate this unusual site and the extent of tumor development, and to determine the appropriate surgical intervention. A clear understanding of retroperitoneal anatomy is essential for safe removal of such tumors. Complete resection is preferred to prevent local recurrence and malignant transformation. Although root section is inevitable, neurological deficit is unlikely.

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“…time before diagnosis 3 . The benign nature of ordinary spinal schwannomas is well documented [4][5][6][7] . Total surgical removal can usually be achieved and shortterm outcome is favorable in those who are not too severely crippled before operation 5,7 .…”

mentioning

confidence: 99%

Surgical Outcome of Spinal Tumour: Our Experience in Dhaka Medical College & Hospital

Das

Zahan

Rashid

et al. 2019

Bangla J. Neurosurgery

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Introduction: Surgical outcome of spinal tumour varies depending on a number of factors such as: site of tumour, compression within the spinal canal, the histological characteristics of tumour, the neurological progression and initial response to corticosteroid therapy, patient’s age, comorbidity, tumour extension, involvement of neighboring structures and organs etc. Materials & Methods: The 86 patients with spinal tumour underwent surgery by our team in 7 years (2011-2018) were reviewed retrospectively. Discussion: Analysis of the surgical outcome of our spinal tumour patients was done on different variables like age, sex, presenting symptoms, neuroimaging, comorbidities etc. The aim of surgery was decompression of the spinal cord, total removal of the tumour when possible and spinal stabilization when needed. Out of our 86 patients with spinal tumour, extradural tumour comprises 18, intradural tumour 56 and intramedullary tumour 12. Conclusion: The aim of this study is to analyze the data to made conclusion for more effective strategy as per site, size, type, resectibility and histological variety to establish and effective treatment protocol and prevention of per-operative and post-operative complications. Intradural extramedullary tumour can be radically resected with no mortality and minimal peri-operative morbidity. But resection of intramedullary spinal tumour is difficult, hazardous and usually incomplete, so needs much more skilled and meticulous surgical hands. Bang. J Neurosurgery 2019; 8(2): 63-67

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Spinal Neurinomas. — A comprehensive clinical and statistical study on 47 cases

Cited by 20 publications

References 1 publication

Dumbbell C2 Schwannomas Involving Both Sensory and Motor Rootlets: Report of Two Cases

Dumbbell C2 Schwannomas Involving Both Sensory and Motor Rootlets: Report of Two Cases

Presacral Solitary Giant Neurofibroma Without Neurofibromatosis Type 1 Presenting as Pelvic Mass. Case Report.

Surgical Outcome of Spinal Tumour: Our Experience in Dhaka Medical College & Hospital

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