Thoracic intramedullary schwannoma

Brown, Karen; Dean, Audrey; Sharr, M. M.

doi:10.1046/j.1365-2990.2002.00415.x

Cited by 16 publications

(10 citation statements)

References 21 publications

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“…The origin of intramedullary schwannoma is not the parenchyma of the normal central nervous system (which lacks Schwann cells) and remains controversial. Some theories of etiology 4,6,15) suggest that the tumor originates from Schwann cells in the entry zone of the dorsal root, subpial extension of Schwann cells along the perivascular nerve plexus of spinal cord vessels, ectopic neural crest cells during embryogenesis, Schwann cells differentiated from multipotential mesenchymal elements of the central nervous system, and proliferation of Schwann cells associated with trauma or chronic inflammatory disease. In this study, one patient had a tumor at the C2-C3 levels and Arnold-Chiari malformation, so the pathogenesis was hypothesized to be long-term stimulation leading to chronic inflammatory disease.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Intramedullary Spinal Schwannomas

Yao

Chen

et al. 2011

Neurol. Med. Chir.(Tokyo)

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Intramedullary spinal schwannomas are rare benign spinal cord tumors and are easily misdiagnosed because of the imaging characteristics shared with intramedullary glioma. Correct preoperative definitive diagnosis is essential for treatment and prognosis. To improve the preoperative diagnostic strategy, clinical and imaging data of seven patients with intramedullary spinal schwannoma (6 men, mean age 44 years, mean duration of illness 4.2 years) treated in our department between 2003 and 2010 were collected and retrospectively evaluated. The cervical cord was affected in five patients, followed by the thoracic cord in two. All seven cases were misdiagnosed as intramedullary glioma based on the imaging characteristics. Comparison of the clinical features of these 7 patients with those of patients with intramedullary tumors (173 ependymomas and 70 astrocytomas) admitted during the same period revealed significant differences in somatic pain and root pain as the initial symptoms between intramedullary spinal schwannomas and ependymomas (p ＝ 0.005) and between intramedullary spinal schwannomas and astrocytomas (p ＝ 0.019), but not between ependymomas and astrocytomas (p ＝ 0.175). Root or somatic pain as an initial symptom is important for the preoperative diagnosis of intramedullary spinal schwannoma, especially if the imaging characteristics are not entirely specific.

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Section: Discussionmentioning

confidence: 99%

Preoperative Diagnosis of Intramedullary Spinal Schwannomas

Yao

Chen

et al. 2011

Neurol. Med. Chir.(Tokyo)

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“…The locations of previously reported intramedullary schwannomas involve the cervical cord about 6 times as often as thoracic tumors, and lumbar involvement is the least common [13,14,15]. Patients with intramedullary schwannomas were 9–75 years old (mean age 40) and showed a male preponderance [1].…”

Section: Discussionmentioning

confidence: 99%

“…During this embryonic development, Schwann cell nests would be pinched off from the segmentation of the neural crest. However, the fact that the aged showed a higher incidence of spinal schwannosis than children contradicts this theory, and a general lack of association between antecedent trauma history and the tumor argues against this theory [13,25]. Second, perivascular Schwann cells near the nerve plexus penetrating the parenchyma of the spinal cord are another plausible source [6,26].…”

Section: Discussionmentioning

confidence: 99%

Thoracic Pediatric Intramedullary Schwannoma: Report of a Case

Kim

Suh²,

Shin

2009

Pediatr Neurosurg

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Schwann cells are generally present in the nerve root, not in the spinal cord. Therefore, intramedullary schwannomas are rare and correct preoperative diagnosis is often difficult. To date, less than 50 cases of intramedullary schwannoma with no sign of neurofibromatosis have been reported in the English literature, of which 5 occurred in children. Here, we report a case of primary thoracic intramedullary schwannoma which occurred at the age of 11, confirmed by intraoperative frozen biopsy. The patient presented with decreased sensation below the T6 dermatome at the right side and right lower extremity weakness with urge incontinence. The ideal treatment for intramedullary schwannoma of histologically benign nature is surgical resection. However, the mass was subtotally resected due to unfavorable intraoperative somatosensory-evoked potential findings, and postoperative fractionated radiotherapy followed. She has been alive with the residual intramedullary mass with no discernible changes during the 11.5 years of follow-up. When neurosurgeons, pediatricians and radiologists encounter an intramedullary tumor in a pediatric patient, intramedullary schwannoma should be included in the differential diagnoses because it might be curable if excised.

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“…Neoplastic transformation, that is, schwannoma, might also occur. 3,5,11 These nerves and tangled microneuromas are sometimes referred to as ''schwannosis,'' 1,4 a term that does not do justice to the central role of axon sprouting in the lesion.…”

Section: Discussionmentioning

confidence: 99%

Intramedullary Amputation Neuromas Associated With Spinal Ependymomas

Johnson

Burger

2009

American Journal of Surgical Pathology

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We report 5 spinal intramedullary masses containing combined ependymoma and traumatic neuroma. The ependymomas, grade II "cellular" types, were intermixed with or separate from wavy, vaguely fascicular tissue that contained multiple axons immunoreactive for neurofilament protein. The neuromas presumably arose from small perivascular nerve twigs that have been implicated in the pathogenesis of intramedullary neuromas in non-neoplastic spinal diseases. Pathologists should be aware of this distinctive intramedullary tissue that is not to be confused with a neoplasm.

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Thoracic intramedullary schwannoma

Cited by 16 publications

References 21 publications

Preoperative Diagnosis of Intramedullary Spinal Schwannomas

Preoperative Diagnosis of Intramedullary Spinal Schwannomas

Thoracic Pediatric Intramedullary Schwannoma: Report of a Case

Intramedullary Amputation Neuromas Associated With Spinal Ependymomas

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