Totally cystic intradural schwannoma in thoracic region

Kumar, Sushil; Gupta, Raghavendra; Handa, Amit; Sinha, Rajeshwari

doi:10.4103/1793-5482.145570

Cited by 9 publications

(11 citation statements)

References 10 publications

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“…Most schwannomas are solid and may have cystic components; however, totally cystic schwannomas are rare. Reported cases have usually been in close proximity to the spine and, consequently, have presented with neurological symptoms such as back ache and paresis [ 2 ], rather than the respiratory symptoms seen in our case.…”

Section: Discussionmentioning

confidence: 86%

“…Schwannomas are usually solid tumors, although cystic changes have been commonly described. Totally cystic schwannomas are much less commonly encountered and those occurring in the thorax, especially the mediastinum, are exceedingly rare; only 10 cases of predominantly cystic schwannomas have been reported in the literature [ 2 ] These tumors can be confused with other cystic masses of the mediastinum, both congenital and acquired [ 3 ]. Most mediastinal schwannomas are asymptomatic and may only be discovered on routine imaging [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Rare Presentation of a Posterior Mediastinal Cystic Schwannoma as a Large Pleural Effusion

Mubashir¹,

Salam²,

Sonawalla³

et al. 2017

Cureus

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A 46-year-old man presented with shortness of breath and recurrent, left-sided pleural effusions. A computed tomography (CT) scan of the chest showed a large, left-sided pleural effusion with a mass in the posterior mediastinum. A pleural tap showed lymphocytic exudate. The biopsy of the mass was inconclusive. A left posterolateral thoracotomy was performed, which showed a large posterior mediastinal mass adherent to the left lung. The mass was completely excised and the histopathology proved it to be giant predominantly cystic schwannoma. The pleural effusion resolved after tumor resection.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Rare Presentation of a Posterior Mediastinal Cystic Schwannoma as a Large Pleural Effusion

Mubashir¹,

Salam²,

Sonawalla³

et al. 2017

Cureus

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“…The majority (approximately 70%) of the mobile spinal tumors were found to be schwannoma, and all the tumors were solid or heterogeneously solid. In addition, only 14 cases of spinal schwannomas have been reported to be cystic [3,17–23]. To the best of our knowledge, this is the first report of a mobile spinal schwannoma with a completely cystic appearance.…”

Section: Discussionmentioning

confidence: 97%

Mobile Spinal Schwannoma with a Completely Cystic Appearance

et al. 2019

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Patient: Female, 48 Final Diagnosis: Spinal schawnnoma Symptoms: Dysuria • leg pain Medication: — Clinical Procedure: — Specialty: Orthopedics and Traumatology Objective: Challenging differential diagnosis Background: Spinal schwannomas are benign tumors arising from Schwann cells. Although they have been well described, tumor movement in the spinal canal is an extremely rare finding, and entirely cystic spinal schwannomas have rarely been reported. This is the first report of a spinal schwannoma that simultaneously exhibited both these unusual features. Case Report: A 48-year-old female presented with dysuria and right leg pain. Initial magnetic resonance imaging (MRI) revealed a well-delineated intradural cystic lesion at the level of L4–S1 vertebrae that was isointense with cerebrospinal fluid on both T1- and T2-weighted images. A follow-up MRI 6 months later showed that the tumor had moved to the level of L2–L4; it also revealed tortuous configuration of nerve roots of the cauda equina. The tumor was resected, and a diagnosis of schwannoma with extensive cystic degeneration was pathologically confirmed. Conclusions: Various possible mechanisms have been suggested for the mobility of extramedullary tumors. In the present case, MRI findings indicated the cause of the tumor movement might be attributed to the laxity of nerve roots. Besides, it is highly atypical for a schwannoma to present an entirely cystic appearance, and the combination of the 2 extraordinary features made preoperative diagnosis difficult. However, 16 out of 22 (73%) of previously reported mobile spinal tumors were schwannomas, so the differential diagnosis for a mobile spinal tumor should include schwannoma, even when the lesion seems entirely cystic on MRI. To minimize the risk of complications and additional surgical dissection, physicians should acknowledge that spinal tumors can migrate.

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“…More than 50% of schwannomas are IDEM tumours, 25% are totally extradural, and 15% are both intra-dural and extradural; only a small number of cases were found to be intramedullary [6]. Cystic schwannomas are more commonly seen in the lumbar region and less frequently seen in the thoracic and cervical regions [9].…”

Section: Discussionmentioning

confidence: 99%

Thoracic cystic schwannoma: case report and review of literature

Samman

Bardeesi²,

Alzahrani

2021

Spinal Cord Ser Cases

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Introduction Schwannomas are the second most common type of intra-dural lesions involving the thoracic spine. They are frequently seen as solid and heterogeneous lesions. Totally cystic thoracic schwannomas represent a rare pathological schwannoma variant, with only four cases reported in the English literature to our knowledge. Case presentation We report an 80-year-old male who presented with upper back pain for 3 months. Magnetic resonance imaging (MRI) showed a cystic lesion at the level of T6-T7 with peripheral contrast enhancement. The lesion was removed in total surgically with complete resolution of the patient's symptoms. Discussion The diagnosis of cystic schwannomas is often delayed due to the paucity of symptoms and the lack of meticulous investigation. The presence of rim enhancement on contrast-enhanced MRI may be the only clue for the diagnosis. It is important to consider cystic schwannomas in the differential diagnosis of cystic spinal lesions since the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.

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Totally cystic intradural schwannoma in thoracic region

Cited by 9 publications

References 10 publications

Rare Presentation of a Posterior Mediastinal Cystic Schwannoma as a Large Pleural Effusion

Rare Presentation of a Posterior Mediastinal Cystic Schwannoma as a Large Pleural Effusion

Mobile Spinal Schwannoma with a Completely Cystic Appearance

Thoracic cystic schwannoma: case report and review of literature

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