Melanotic spinothoracic schwannoma.

Paris, Fernanda de; Cabanès, Jean-Louis; Muñoz, Cristina Parrilla; Tamarit, L

doi:10.1136/thx.34.2.243

Cited by 15 publications

(4 citation statements)

References 11 publications

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“…GTR with or without radiation therapy is the favored treatment for MS.[ 37 , 46 ] Depending on the size and local invasion of the tumor, GTR may or may not be possible without inducing significant iatrogenic neurological deficit. In cases of subtotal resection or particularly malignant-appearing tumor, adjuvant therapy has been employed with positive outcomes;[ 40 , 47 , 52 , 59 , 64 ] however, a definite mortality benefit has not yet been shown. The use of chemotherapy in MS has not been thoroughly studied.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic spinal melanotic schwannoma presenting as acute chest pain: A case report and literature review

Soyland

Goehner

Hoerschgen

et al. 2021

Surgical Neurology International

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Background: Melanotic schwannoma (MS) is a rare variant of peripheral nerve sheath tumor. MS commonly arises along the spinal nerve sheath. Patients most often experience pain along the dermatome of the affected nerve root. Symptoms development is usually insidious. About half of MS cases are associated with Carney complex, a multi-neoplastic disorder. The remaining cases arise spontaneously. About 10–44% of these tumors undergo malignant transformation. Case Description: We describe a case of hemorrhagic MS presenting as acute chest pain mimicking myocardial infarction, a presentation which has not yet been described in the literature. Neurologic examination did not reveal any abnormalities. Myocardial infarction was ruled out in the ER, and a chest CT angiogram was ordered for evaluation of PE or aortic dissection which revealed an intradural extramedullary dumbbell-shaped mass extending through the left vertebral foramen at the level of T8. MRI revealed a heterogenous mass that was hyperintense with T2 and hypointense with T1-weighted imaging. The patient underwent an open laminectomy of the left T8 and T9 vertebrae and gross total resection (GTR) of a hemorrhagic black tumor. Microscopic examination showed fascicles and nests of plump spindle cells with variable intracellular melanin. Immunohistochemistry showed the cells to be positive for S100, SOX10, HMB-45, and MART-1, confirming diagnosis of MS. Two months after the operation, the patient was doing well and is free of recurrence. Conclusion: GTR is considered the optimal treatment for MS; radiotherapy and chemotherapy may be considered but have not been shown to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Hemorrhagic spinal melanotic schwannoma presenting as acute chest pain: A case report and literature review

Soyland

Goehner

Hoerschgen

et al. 2021

Surgical Neurology International

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“…[1][2][3][4][5][6][7][8] We found a mean age of about 50 years old, the masculine gender being present in slightly more than half of the cases reviewed. The thoracic level was the most affected, with prevalence of extramedullary location (eight of the eleven reported cases), as well as in our patient, in which we found the development of extramedullary and intradural injury.…”

Section: Discussionmentioning

confidence: 60%

Melanotic schwannoma of the lumbar spine: a case report and literature review

et al. 2015

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Schwannomas are benign tumors, usually solitary, encapsulated, slow-growing, which have their origin in differentiated neoplastic Schwann cells with extramedullary intradural usual development related to nerve roots. The melanotic schwannoma is a variant of these tumors whose location in almost one third of cases is on the posterior spinal nerve root, with a nonspecific clinical presentation. Magnetic resonance imaging is the most widely used test for the diagnosis, revealing hyperintense T1-weighted sequences and hypointense T2-weighted sequences. Diagnostic confirmation is obtained by histological and immunohistochemical studies, in which there is intense cytoplasmatic pigmentation. There are two distinct types of melanotic schwannomas: sporadic and psammomatous, the latter related to the called Carney complex, a form of multiple endocrine neoplasm with familiar character. In literature we found few cases of these neoplasms, the largest series consisting of five cases. The objective of this study is to report a rare case of melanotic schwannoma of the lumbar spine of the sporadic type of extramedullary location. We also present a brief review of the literature containing the main characteristics of the tumor, including its different forms, differential diagnoses, data from histological and immunohistochemical studies as well as the currently recommended approach in order to contribute to a better understanding of this neoplasm.Keywords: Spine; Spinal neoplasms; Schwann Cells; Manipulation, spinal. RESUMO Os schwannomas são tumores benignos, geralmente solitários, encapsulados e de crescimento lento, que têm sua origem nas células de Schwann neoplásicas diferenciadas, com desenvolvimento habitual extramedular intradural relacionado com as raízes nervosas. O schwannoma melanocítico é uma variante dessas neoplasias cuja localização em quase um terço dos casos está na raiz nervosa posterior

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“…The dorsal location represents 30.5% of the spinal melanotic schwannoma [ 41 ]. Until today we were able to find 47 spinal cases of extramedullary melanotic neurinoma in literature (Table 1 ) [ 1 , 2 , 3 , 5 , 6 , 7 , 11 , 12 , 13 , 16 , 18 , 20 , 21 , 26 , 28 , 30 , 31 , 33 , 34 , 35 , 38 , 39 , 44 , 45 ]. The clinical presentation is not specific but similar to that of other extramedullary spinal tumors (radicular pain, dysesthesias, progressive sensorial-motor deficits).…”

Section: Discussionmentioning

confidence: 99%

Dorsal dumb-bell melanotic schwannoma operated on by posterior and anterior approach: case report and a review of the literature

2006

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The schwannomas are benign tumors originating from Schwann cells which constitute the nerve sheath. The dorsal pigmented type of schwannomas is relatively rare (Goldstein in Am J Med Genet 86:62–65, 2004; Kurtkaya-Yapicier in Histol Histopathol 18(3):925–934, 2003). There are two distinct types of melanotic schwannoma: the sporadic melanotic schwannomas and the psammomatous melanotic schwannomas of Carney complex. We report a case of a patient harboring a right dorsal dumb-bell melanotic schwannoma and left adrenal mass. The patient underwent a surgical procedure for en bloc total removal of the mass by a posterior and anterior approach. Histopathological examination revealed the diagnosis of melanotic schwannoma. At present, we have no reliable marker of histopathological malignancy of melanotic schwannoma so the follow-up period ought to continue for a period of more than 5 years. As the total removal of the melanotic neurinomas is mandatory to prevent possible malignant transformation of the tumor recurrence or regrowth, we believe that the posterior and trans-thoracic approach are the most suitable one for the dorsal dumb-bell schwannoma.

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Melanotic spinothoracic schwannoma.

Cited by 15 publications

References 11 publications

Hemorrhagic spinal melanotic schwannoma presenting as acute chest pain: A case report and literature review

Hemorrhagic spinal melanotic schwannoma presenting as acute chest pain: A case report and literature review

Melanotic schwannoma of the lumbar spine: a case report and literature review

Dorsal dumb-bell melanotic schwannoma operated on by posterior and anterior approach: case report and a review of the literature

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