Spinal Schwannomatosis Mimicking Metastatic Extramedullary Spinal Tumor

Abstract

Intradural extramedullary (IDEM) tumors are the most commonly observed intraspinal tumors, comprising over 60% of tumors found within the spinal canal, and the vast majority of these lesions are benign lesions. IDEM metastases are rare, but if they occur, they commonly manifest as leptomeningeal disease, secondary to drop lesions from intracranial metastases from adenocarcinomas of the lung, prostate cancer, breast cancer, melanoma, or rarely, as a result of lymphomas. The purely non-neurogenic origin of IDEM metastases is rare. Herein, we describe a patient with a previous history of treated colon cancer who presented with a progressive neurological deficit and whose imaging revealed multiple intradural, extramedullary and osseous lesions at the cervical and thoracolumbar spines. With the previous known primary and multiplicity of the lesions, an initial diagnosis of spinal metastasis was made, But it was proven to be schwannoma on histology. We emphasize the diagnostic dilemma in this case and the importance of detecting subtle imaging findings, which may be helpful to differentiate between metastatic disease and a second primary tumor.

Animal models of brain and spinal cord metastases of NSCLC established using a brain stereotactic instrument

“…Spinal cord metastasis—also malignant metastasis—is characterized by rapid clinical progression and a poor prognosis [ [29] , [30] , [31] , [32] ]. Primary tumors that can develop spinal cord metastasis include lung cancer, breast cancer [ 33 ], and melanoma [ 34 ], etc., with lung cancer being the most prone to spinal cord metastasis [ 35 , 36 ]. At a later stage, patients with spinal cord metastasis show severe pain in the lower back, leading to impaired neurological function, diminished sensory ability, and general weakness [ 30 ].…”