Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review

Lim, Dongwook

doi:10.1016/j.ijscr.2023.108396

Cited by 2 publications

(4 citation statements)

References 20 publications

(22 reference statements)

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“…Herniated lumbar disc is one of the most frequent symptomatic spinal pathologies, which can cause low back pain and radiculopathy [ 1 , 2 ]. Schwannomas, which are benign tumors that originate from Schwann cells of the myeline sheath, can cause similar symptoms [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Schwannomas, which are benign tumors that originate from Schwann cells of the myeline sheath, can cause similar symptoms [ 3 , 4 ]. They, however, can be locally aggressive, and although rare, have been reported to cause serious neurological deficits, including cauda equina syndrome (CES), a neurosurgical emergency characterized by compression of nerves at the lower end of the spinal cord, resulting in symptoms such as lower back pain, leg weakness, bladder and bowel dysfunction, and saddle anesthesia [ 1 , 5 , 6 ]. Migratory spinal tumors are rare with schwannomas are the most common type to move, as other common primary intraspinal neoplasms, such as meningiomas and ependymomas, are fixed in their position [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

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Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Khorram,

Watson

2024

Am J Case Rep

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Patient: Male, 62-year-old Final Diagnosis: Mobile spinal schwannoma Symptoms: Difficult urination • lower extremity pain • lower extremity weakness Clinical Procedure: Surgical resection Specialty: Neurosurgery Objective: Rare coexistence of disease or pathology Background: Aside from the rarity of mobile spinal schwannomas, the coexistence of these tumors with herniated intervertebral disc is also scarce. Furthermore, cauda equina syndrome (CES), as a manifestation of intraspinal schwannomas has been reported rarely. Described here is a case of simultaneous lumbar disc bulge and mobile spinal schwannoma presented with intermittent symptoms of CES. Case Report: A 62-year-old man presented with severe but intermittent leg pain for 2 weeks, which later progressed to an episode of lower extremity weakness and difficulty in urination. Magnetic resonance imaging revealed an intraspinal tumor that moved in position relative to the L1–2 disc bulge on scans 6 h apart, with associated spontaneous regression in symptoms. The tumor was found to be a mobile spinal schwannoma, originated from a nerve root. A standard microdissection technique was used to remove the tumor through a spinous process-sparing unilateral approach, with complete laminectomy of L1. Use of intraoperative ultrasound facilitated the accurate tumor localization. Postoperatively, the patient no longer had symptoms. Conclusions: This report presents a combination of a common spinal pathology, intervertebral disc herniation, alongside a rare condition, mobile spinal schwannoma, whose uncommon clinical manifestations, such as CES can cause irreversible neurological deficits. Surgeons need to remain vigilant of potential atypical scenarios when treating patients. Surgical treatment challenges regarding the mobility of tumors, such as accurate localization, should be addressed using intraoperative imaging to avoid wrong-level surgery. To mitigate the irreversible neurological complications, patients should receive comprehensive information for alarming signs of CES.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Khorram,

Watson

2024

Am J Case Rep

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“…We read with interest the article by Lim D.-J., published in your esteemed journal, reporting the case of acute development of cauda equina syndrome due to a schwannoma located on the level of L3 vertebra [ 1 ]. The article provoked some questions for us, to which we did not find answers in the publication.…”

mentioning

confidence: 99%

“…The atypicality of a tumor concerns its histological structure or its location. Schwannomas originate from the Schwann sheaths of the spinal roots, which are outside the spinal cord, and several cellular types have been described: cellular schwannoma, plexiform schwannoma, and ancient schwannoma [ 1 , 2 ]. Schwannomas are tumors with a benign biological behavior.…”

mentioning

confidence: 99%

Letter to Editor regarding: “Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review”

Kitov,

Davarski,

Milkov

2023

International Journal of Surgery Case Reports

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Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review

Cited by 2 publications

References 20 publications

Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Simultaneous L1-2 Bulged Disc and Mobile Spinal Schwannoma Causing Cauda Equina Syndrome: A Rare Case Report

Letter to Editor regarding: “Atypical intradural extramedullary spinal schwannoma causing cauda equina syndrome: A case report and literature review”

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