• Journal of Korean Neurosurgical Society
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• 제51권2호
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• pp.105-108
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• 2012

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.

• Journal of Korean Neurosurgical Society
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• 제47권6호
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• pp.454-457
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• 2010

Pure ventral midline giant schwannoma is an extremely rare entity. Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated giant pan cervical extramedullary schwannoma in an 18-year-old male patient with compressive myelopathy and sphincter involvement is presented. Spinal MR imaging showed a midline ventrally situated extramedullary tumor with severe spinal cord compression extending from clivus to C7 vertebra. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. Post operative MR imaging showed no evidence of the tumor. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed.

• Journal of Korean Neurosurgical Society
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• 제54권4호
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• pp.350-354
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• 2013

To present a rare case of a cystic giant schwannoma of the sacrum mimicking aneurysmal bone cyst (ABC). A 54-year-old man visited our institute complaining left leg weakness and sensory change for several years. Magnetic resonance imaging revealed a large multilocular cystic mass with canal invasion and bone erosion confined to left S1 body. The lesion showed multiple septal enhancement without definite solid component. Initially the tumor was considered as ABC. The patient underwent grossly-total tumor resection with lumbosacral reconstruction via posterior approach. The tumor was proved to be a cystic schwannoma. The postoperative course was uneventful and the patient was relieved from preoperative symptoms. We present a rare case of pure cystic giant schwannoma confined to sacrum mimicking ABC. The surgical treatment is challenging due to the complex anatomy of the sacrum. Schwannoma should be considered in the differential diagnosis of osteolytic sacral cysts.

• Journal of Korean Neurosurgical Society
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• 제30권4호
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• pp.509-513
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• 2001

Sacral schwannoma is a rare lesion with a tendency to reach large proportions. The benign schwannoma rarely involves the vertebral bodies extensively. The authors report a case of giant intrasacral schwannoma in 30-year-old woman who had intermittent lower back pain during 3 years period. CT and MRI showed a destructive mass lesion within the upper part of sacrum with a large mass extending into the presacral space. The patient underwent combined surgery consisted of anterior transabdominal approach and posterior sacral laminectomy and total removal of tumor. The characteristics of the lesion were discussed with a review of literatures.

• Tuberculosis and Respiratory Diseases
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• 제75권2호
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• pp.71-74
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• 2013

Benign schwannoma is the most common neurogenic tumor in the mediastinum. Mediastinal benign schwannomas are most often asymptomatic and rarely accompanied by bloody pleural effusion. In the clinical analysis of 7 cases of pulmonary schwannomas, pleural effusion, and blood invasion were evident in 3 patients with malignant schwannoma. Herein, we report a rare case of giant, benign schwannoma presented with total collapse of right lung by massive, bloody pleural effusion.

• Journal of Korean Neurosurgical Society
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• 제30권9호
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• pp.1144-1149
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• 2001

Schwannomas of the jugular foramen, originating from the glossopharyngeal nerve, vagus and accessory nerve represent approximately 0.17-0.72% of all intracranial tumor, and consists of 1.4-2.9% of all intracranial schwannomas. The clinical presentation of these tumors varies significantly according to originated nerve and it's growth pattern. Magnetic resonance(MR) image and temporal bone computed tomography(CT) scan have a major role for diagnosis of such tumor. The treatment of choice is total resection whenever possible. Generally, suboccipital approach is sufficient for the removal of the tumor, but in case with large size, combination of resection of petrous part of temporal bone with or without transection of sigmoid sinus is may be necessory. We have recently experienced one case of giant jugular foramen schwannoma and postoperative fatal complication in a 34-year-old male who was treated with combined posterior petrous and suboccipital approach with transection of sigmoid sinus

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제48권2호
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• pp.111-116
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• 2022

Retropharyngeal schwannoma is rare. To the best of our knowledge, only 18 cases have been published in the English literature. Complete surgical excision is the treatment of choice for schwannomas. Transoral approaches have been applied for smaller lesions, and external cervical approaches are preferred for larger and more complex lesions. In this report, we present a case of large retropharyngeal schwannoma that was excised using an endoscopic-assisted transoral approach with palatal splitting. Postoperative functional and oncologic outcomes were satisfactory with no reported intraoperative/postoperative complications.

• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.21-24
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• 2016

Esophageal schwannoma is a very rare submucosal tumor. We report successful management of esophageal schwannoma in a 41-year-old man who complained of progressively worsening dysphagia. A huge submucosal tumor was found via endoscopy and a chest computed tomography scan. Esophagectomy was performed with no post-operative complications. Post-operative immunohistochemistry staining showed a positive result for S-100 and negative results for c-kit and CD34. The post-operative mild dysphagia persisted, and the follow-up endoscopic findings revealed anastomosis site stenosis. Approximately 2 months later, we performed endoscopic balloon dilatation. We report herein a case of esophageal schwannoma with reviews.

• Journal of Gastric Cancer
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• 제6권1호
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• pp.47-51
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• 2006

위에서 생기는 점막하 종양은 내시경적 조직검사로는 그 기원을 알기 어려운 경우가 많다. 이러한 점막하 종양 중, 슈반 세포(Schwann cell)로부터 분화하여 생기는 종양을 신경초종(Schwannoma)이라고 하며, 위에서 생기는 전체 종양의 0.2%를 차지한다고 알려져 있다. 이 증례는 2개월 전부터 시작된 다량의 흑색변과 빈혈을 주소로 내원한 57세 여자 환자에 대한 보고이다. 복부 컴퓨터 단층 촬영 및 상부 위장관 내시경에서 위 분문에서 3 cm정도 아래부터 위각 직상부까지 위체부 소만을 대부분 차지하는 약 8 cm 이상의 돌출된 종양이 관찰되었고, 수 차례에 걸친 내시경적 조직검사를 시행하였으나 괴사조직과 육아종성 조직, 만성 위염 소견만 반복해서 나왔다. 출혈을 동반한 진행성 위암, 림프종 등을 생각하여 정확한 진단 및 출혈에 대한 치료를 위해 수술을 시행하였다. 술 후 조직검사에서 전반적으로 소엽상 형태(lobulating pattern)로 주변에 림프구 침윤(lymphocyte cuffing)이 있었고 책상핵(palisading nuclei), 방추세포(spindle-cell) 등이 보였다. C-kit, CD34, SMA 모두 음성이었으며 S-100 양성으로 신경초종으로 진단되었다.

• 대한정형외과학회지
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• 제55권6호
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• pp.511-519
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• 2020

목적: 신경초종은 말초신경에 주로 발생하는 양성종양이나 크기가 크거나 신경 이외의 부위에서 발견될 경우 악성 연부조직 종양으로 오인하기 쉽다. 저자들은 크기 5 cm 이상의 신경초종 50예의 1) 원발 위치의 분포 및 임상증상여부, 2) 술 전 방사선 및 병리학적 진단 결과와 진단적 정확도에 대해 알아보았다. 대상 및 방법: 신경초종으로 확진된 214예 중 자기공명영상(magnetic resonance imaging, MRI)상 종양의 최대직경이 5 cm 이상인 종양 50예를 추출하였다. 이를 주요신경 기원, 근육 내, 골 내의 원발위치에 따라 분류하였고 구체적인 해부학적 위치를 분석하였다. 결과: 전체 코호트에서 원발위치에 따라 분류하였을 때 주요 말초신경에 생긴 종양이 14예, 근육 내 발생이 31예, 골 내 발생이 5예였다. 신경초종의 평균크기는 7 cm였으며 근육내 신경초종이 평균 8 cm로 가장 컸다. MRI를 통한 영상학적 진단에서 전체 50예 중 33예(66.0%)는 양성 신경종양으로, 15예(30.0%)는 악성종양으로 판독하였으며, 나머지 2예(4.0%)는 각각 결핵 농양, 건활막 거대세포종으로 보고되었다. 골내 신경초종 5예 중 영상학적으로 신경초종으로 진단한 예는 없었다. 임상증상에서는 주요 신경기원의 경우는 Tinel sign이 78.6%로 많았고(11/14), 주요 신경 외 기원 종양에서는 종괴 촉지 증상이 93.5%로 가장 많았으며(29/31) 증상기간도 평균 66.6개월로 가장 길었다. 병리학적 진단을 위해 생검을 시행한 총 38예 중 86.8%에서는 신경초종으로 진단하였다. 합병증은 수술 후 합병증이 총 2예였으며 종양절제 후 출혈로 재수술이 필요했던 경우와 수술 후 경한 신경마비가 발생한 경우였다. 결론: 5 cm 이상의 근육 내 종양을 진단할 때 장기간의 종괴인지 소견이 있고, MRI상 비특이적인 소견일 경우에는 양상 신경종양일 가능성도 염두에 두고 조직학적 확진 후 치료를 시행하는 것이 과잉 치료 가능성을 줄이는 데 도움이 될 것으로 생각된다.