Ancient Schwannoma of the Cauda Equina: Our Experience and Review of the Literature

Abstract

Ancient schwannomas (AS) are exceedingly rare variant of common schwannomas (CS). Only two cases involving the cauda equina region have been previously reported in literature. AS are typically associated with a higher histological degree of degenerative changes (Antoni B areas). It is of peculiar importance, according to our opinion, to outline that, because of their extremely slow growth (which explains the increase of the degenerative changes in respect to the CS) and their typical soft consistency in respect to their standard counterparts, AS usually imply an even better prognosis.

Ancient Schwannoma as an exceptional thoracic spinal tumor: A case report

“…Ancient schwannoma is an uncommon variant of schwannomas and accounts for less than 1% of all schwannomas [ 3 ]. As a probable consequence of their slow growth rate, ancient schwannomas display some degenerative changes histopathologically such as calcification, cystic necrosis, hemorrhage, intravascular thrombosis, perivascular hyalinization, and relative loss of Antoni type A areas in course of time.…”

A cauda equina „ancient” típusú schwannomája

“…Rövidítések CEA = carcinoembryonalis antigén; CD = (cluster of differentiation) differenciációs klaszter; CT = (computed tomography) komputertomográfia; EMA = epithelialis membránantigén; HE = hematoxilin-eozin (festés); Ki67 = KI67-antigén; MRI = (magnetic resonance imaging) mágnesesrezonancia-képalkotás; STIR = (short T1 inversion recovery) rövid T1-inverziós képtechnika A cauda equina daganatok ritka entitások, amelyek incidenciája kevesebb mint 6% a gerinc primer neoplasmái között [1].…”

“…A fej-nyak régió, a végtagok, a medence és a retroperitoneum a predilekciós helyek. Ritkábban fordulnak elő a gerincvelőben, a cauda equinában pedig csak elvétve jelennek meg [1]. A cauda equinát érintő schwannomák gyakran lumbagós tünetekkel jelentkeznek, ezért könnyű összetéveszteni őket a degenerativ gerincbetegségek által okozott panaszokkal.…”

An Overview of Central Nervous System Tumours

“…Typically these are large tumours of long duration that lack mitotic figures, and usually show other degenerative changes including cystic necrosis, stromal edema, xanthomatous change, fibrosis, calcification, haemorrhage, and perivascular hyalinization [164,[166][167]. ASs are usually deeply located, and mostly affects the head and neck, cervical region, pelvis, retroperitoneum, and flexor aspect of the limbs [162][163][164][165][166][167][168]. Histologically, ancient schwannomas show areas of cellularity and areas of myxoid matrix [164].…”