Giant erosive spinal schwannomas: surgical management

Özdemir, Nail; Bezircioğlu, Hamdi; Akar, Ömer

doi:10.3109/02688697.2010.487129

Cited by 22 publications

(17 citation statements)

References 15 publications

(41 reference statements)

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“…Giant invasive spinal schwannomas may be encountered most frequently in the cervical spine [16] or lumbosacral and sacral spine [5,6]. In the present review of pediatric cases, the lumbar spine was most commonly affected (two cases), followed by the lumbosacral spine (one case), and thoracic spine (one case).…”

Section: Discussionmentioning

confidence: 80%

“…The optimal surgical strategy for giant invasive spinal schwannomas involves decompression of the spinal cord and gross total resection, while preserving nearby neurovascular structures and addressing the potential for vertebral column instability. Reports on the clinical features of giant invasive spinal schwannomas and treatment approaches based on outcome are sparse [14-16]. Moreover, to the best of our knowledge, there have only been three previous descriptions of the clinical features of these tumor and surgical strategies in children [6,17].…”

Section: Introductionmentioning

confidence: 99%

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Giant invasive spinal schwannoma in children: a case report and review of the literature

et al. 2013

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IntroductionGiant invasive spinal schwannoma is defined as a tumor that extends over two or more vertebral levels, erodes vertebral bodies, and extends into the extraspinal space disrupting myofascial planes. Because of its rarity, there have been few published reports describing clinical features and surgical outcomes, especially in the pediatric patient population.Case presentationWe analyzed the medical record, pathologic findings, and radiographic studies of a 14-year-old Hispanic boy who presented to Texas Children’s Hospital with a three-month history of progressive spastic paraparesis. Preoperative computed tomography and magnetic resonance imaging reports showed a large mass lesion centered at the left T7-8 neural foramen with intra- and extraspinal extension, resulting in severe spinal cord compression and vertebral body erosion, and protrusion into the retropleural space and descending aorta. Our patient underwent a single-stage posterior approach for complete resection of the tumor with reconstruction and stabilization of the vertebral column. The pathological examination was consistent with schwannoma. At the six-month follow-up, our patient had resolution of preoperative symptoms and remains neurologically intact without any radiographic evidence of recurrent tumor.ConclusionTo the best of our knowledge, our case represents the fourth child with giant invasive spinal schwannoma reported in the literature. We describe our case and review the literature to discuss the aggregate clinical features, surgical strategies, and operative outcomes for giant invasive spinal schwannoma in the pediatric age group.

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Giant invasive spinal schwannoma in children: a case report and review of the literature

et al. 2013

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“…Although most of the reported case presentations and case series were comprised of sacral GSS, a review of the related literature revealed that many GSS cases are located in the lumbar spine; indeed, 60-70% of GSSs have been reported to be lumbar by other studies 10,13-18. High rates of cervical GSSs have only been reported by Kim et al19 and Özdemir et al,14 who found rates of 50-55% in their series. In our series, most of the GSSs were located in the lumbosacral area (11 cases; 61.1%).…”

Section: Discussionmentioning

confidence: 95%

Alternatives to surgical approach for giant spinal schwannomas

Onen

Şimşek

Naderi

2016

NSJ

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Objective:To review the diagnoses and surgical approach characteristics of giant spinal schwannomas (GSS) patients.Methods:We reviewed the preoperative and postoperative radiological and clinical data, and the surgical aspects of 18 GSS patients who underwent surgery in the Department of Neurosurgery, Umraniye Teaching Hospital and Research State Hospital, Istanbul, Turkey between January 2008 and December 2013.Results:There were 15 (83.3%) female and 3 (16.6%) male patients. The age range was 16-70 years (average: 45.8). Average symptom duration was 1.5 months: (range: 1-48). There was local pain in 15 cases, and radicular pain in 6 cases. The GSSs were most frequently located in the lumbosacral area (11 cases, 61.1%). An extraforaminal surgical approach was employed in 7 cases, a posterior approach was employed in 6 cases, a combined anterior transabdominal and posterior approach was employed in 2 cases, a combined posterior and extraforaminal approach was employed in 2 cases, and a retroperitoneal approach was applied in one case. The tumors were completely excised in all cases. The mean follow-up period was 38.5 months (range: 20-68).Conclusion:Giant spinal schwannomas exhibit unique diagnostic and surgical factors. The selection of an appropriate approach significantly influences the success of the treatment.

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“…Perhaps the follow-up time (mean 1.9 years) was relatively shorter. Additionally, some authors prefer aggressive tumor management for sacral schwannoma via wide resection and total sacrectomy given the risk of local recurrence [17–19]. But this debated strategy often results in sacral nerve dysfunction and more blood loss.…”

Section: Discussionmentioning

confidence: 99%

Clinical features and surgical treatment of sacral schwannomas

et al. 2017

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BackgroundSacral schwannoma is relatively rare and both the early diagnosis and appropriate treatment of sacral schwannomas are equally very challenging.Methods11 sacral schwannoma cases operated at the Second Affiliated Hospital, School of Medicine, Zhejiang University, from 2012 to 2016, were investigated retrospectively and 10 were followed up. All patients were assessed with X-ray, CT and MRI, and underwent an intralesional excision.ResultsOne patient was male, nine were female and the average age was 48 (ranging between 31 and 63). Three patients suffered from back and leg pain, and seven had no obvious symptoms. The average blood loss during surgery was 980ml (ranging between 100 and 2,000ml). Six patients underwent preoperative biopsy. The surgeries were performed via the combination of an anterior and posterior approach in two patients, a posterior approach in seven patients, and an anterior approach in one patient. Residual tumors were not detected in all patients after surgery. Unfortunately, the postoperative complications occurred in three patients, namely bowel and bladder dysfunction (two patients) and cerebrospinal fluid leakage with secondary intracranial infection (one patient). The average follow-up was 22.7 months (8-44 months). All patients were relieved from preoperative symptoms after the last follow-up.ConclusionsThe typical findings of our cases in MRI were a well-circumscribed lesion with a heterogenous signal intensity on T2-weighted image, which may be helpful for preoperative decision-making. Intralesional excision can be successfully performed using single anterior or single posterior or both, and is an important procedure in the treatment of sacral schwannomas.

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Giant erosive spinal schwannomas: surgical management

Cited by 22 publications

References 15 publications

Giant invasive spinal schwannoma in children: a case report and review of the literature

Giant invasive spinal schwannoma in children: a case report and review of the literature

Alternatives to surgical approach for giant spinal schwannomas

Clinical features and surgical treatment of sacral schwannomas

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