Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Giant Cauda Equina Schwannoma with Dystrophic Calcifications : Case Report and Review of the Literature

  • Hyun, Seung-Jae (Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine) ;
  • Rhim, Seung-Chul (Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2010.11.11
  • Accepted : 2012.02.07
  • Published : 2012.02.28
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Abstract

Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was completely removed, with intraoperative neurophysiologic monitoring. Histopathologic examination showed that the tumor was a schwannoma. The patient's postoperative course was uneventful, with urinary function and numbness gradually improving. Although a giant schwannoma accompanied by dystrophic calcification is extremely rare, such a tumor can be removed safely and completely by meticulous dissection and careful neuromonitoring of the cauda equina spinal nerves involved in the tumor.

Keywords

References

  1. Bursztyn EM, Prada A : Intradural cauda equina schwannoma. Surg Neurol 26 : 567-570, 1986 https://doi.org/10.1016/0090-3019(86)90341-1
  2. Cervoni L, Celli P, Scarpinati M, Cantore G : Neurinomas of the cauda equina clinical analysis of 40 surgical cases. Acta Neurochir (Wien) 127 : 199-202, 1994 https://doi.org/10.1007/BF01808766
  3. Dickson JH, Waltz TA, Fechner RE : Intraosseous neurilemoma of the third lumbar vertebra. J Bone Joint Surg Am 53 : 349-355, 1971 https://doi.org/10.2106/00004623-197153020-00016
  4. Hung CH, Tsai TH, Lieu AS, Lin CL, Lee KS, Hwang SL, et al. : Giant invasive schwannoma of cauda equina with minimal neurologic deficit : a case report and literature review. Kaohsiung J Med Sci 24 : 212-217, 2008 https://doi.org/10.1016/S1607-551X(08)70120-7
  5. Jeon JH, Hwang HS, Jeong JH, Park SH, Moon JG, Kim CH : Spinal schwannoma; analysis of 40 cases. J Korean Neurosurg Soc 43 : 135-138, 2008 https://doi.org/10.3340/jkns.2008.43.3.135
  6. Kagaya H, Abe E, Sato K, Shimada Y, Kimura A : Giant cauda equina schwannoma. A case report. Spine (Phila Pa 1976) 25 : 268-272, 2000 https://doi.org/10.1097/00007632-200001150-00021
  7. Kim P, Ebersold MJ, Onofrio BM, Quast LM : Surgery of spinal nerve schwannoma. Risk of neurological deficit after resection of involved root. J Neurosurg 71 : 810-814, 1989 https://doi.org/10.3171/jns.1989.71.6.0810
  8. Kotoura Y, Shikata J, Yamamuro T, Kasahara K, Iwasaki R, Nakashima Y, et al. : Radiation therapy for giant intrasacral schwannoma. Spine (Phila Pa 1976) 16 : 239-242, 1991
  9. Lesoin F, Krivosic I, Cama A, Jomin M : A giant intrasacral schwannoma revealed by lumbosacral pain. Neurochirurgia (Stuttg) 27 : 23-24, 1984
  10. Natarajan M, Rajagopal T, Srinivasan K : A giant schwannoma of cauda equina. Surg Neurol 4 : 367-368, 1975
  11. Ortolan EG, Sola CA, Gruenberg MF, Carballo Vazquez F : Giant sacral schwannoma. A case report. Spine (Phila Pa 1976) 21 : 522-526, 1996 https://doi.org/10.1097/00007632-199602150-00023
  12. Osborn RE, DeWitt JD : Giant cauda equina schwannoma : CT appearance. AJNR Am J Neuroradiol 6 : 835-836, 1985
  13. Rengachary SS, O'Boynick P, Batnitzky S, Kepes JJ : Giant intrasacral Schwannoma : case report. Neurosurgery 9 : 573-577, 1981 https://doi.org/10.1227/00006123-198111000-00016
  14. Saito T, Shimode M, Azuma S, Seichi A : Giant schwannoma of the cauda equina with dural ectasia : a case report. J Orthop Sci 9 : 635-637, 2004 https://doi.org/10.1007/s00776-004-0819-y
  15. Salvant JB Jr, Young HF : Giant intrasacral schwannoma : an unusual cause of lumbrosacral radiculopathy. Surg Neurol 41 : 411-413, 1994 https://doi.org/10.1016/0090-3019(94)90036-1
  16. Santi MD, Mitsunaga MM, Lockett JL : Total sacrectomy for a giant sacral schwannoma. A case report. Clin Orthop Relat Res : 285-289, 1993
  17. Turgut M, ErkuŞ M : Giant schwannoma of the cauda equina : case report and review of the literature. Zentralbl Neurochir 69 : 99-101, 2008 https://doi.org/10.1055/s-2008-1073124
  18. Turk PS, Peters N, Libbey NP, Wanebo HJ : Diagnosis and management of giant intrasacral schwannoma. Cancer 70 : 2650-2657, 1992 https://doi.org/10.1002/1097-0142(19921201)70:11<2650::AID-CNCR2820701114>3.0.CO;2-1
  19. Wu WQ : Management of two giant neurilemomas of the cauda equina. South Med J 73 : 386-388, 1980 https://doi.org/10.1097/00007611-198003000-00036

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