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Baskoro W, Pratama MFR, Rusidi HA, Purnomo AR, Kameswari B. Gross total resection of benign retroperitonealy/intra/paraspinal giant schwannoma. Surg Neurol Int 2024; 15:184. [PMID: 38840621 PMCID: PMC11152551 DOI: 10.25259/sni_267_2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 05/10/2024] [Indexed: 06/07/2024] Open
Abstract
Background Schwannoma is a typically benign nerve sheath tumor. Here, a 30-year-old female underwent resection of a benign retroperitoneal/intra/paraspinal schwannoma. Case Description A 30-year-old female originally had urological surgery to remove an ill-defined retroperitoneal tumor. When she newly presented with right-side low back pain, and the magnetic resonance documented a recurrent/residual L1-L3 intra/paraspinal lesion, she required an additional tumor excision for the removal of the benign schwannoma. Conclusion Spinal surgeons, dealing with benign schwannomas located in the retroperitoneal/intra/paraspinal compartments, need to work collaboratively with other surgeons (i.e., in this case, urologists) to achieve gross total tumor excision, and the best long-term results.
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Affiliation(s)
- Wisnu Baskoro
- Department of Neurosurgery, Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia
| | | | - Hanan Anwar Rusidi
- Department of Neurosurgery, Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia
| | | | - Bidari Kameswari
- Department of Pathology Anatomy, Soeradji Tirtonegoro Central Public Hospital, Klaten, Indonesia
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Vanegas Cerna G, Barrientos Castillo RE, Nurmukhametov R, Baldoncini M, López Lara CE, Rosario A, Ogando YE, Ramirez KM, Lafuente J, Chmutin GE, Montemurro N, Ramirez MDJE. Giant Invasive Intradural Extramedullary Lumbar Schwannoma: A Case Report and Literature Review. Cureus 2023; 15:e40708. [PMID: 37485228 PMCID: PMC10359865 DOI: 10.7759/cureus.40708] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Schwannomas are benign nerve sheath tumors that arise from Schwann cells, which are responsible for producing the myelin sheath that surrounds nerves. They are typically slow-growing and can occur in various locations in the body, including the lumbar region of the spine. We present a case of giant invasive intradural extramedullary schwannoma managed with posterior lumbar interbody fusion (PLIF) and laminectomy with excellent results. A 58-year-old man presented with lower back pain radiating to the right leg for six months. He had no history of trauma or systemic disease. Lumbosacral magnetic resonance imaging (MRI) showed a well-defined mass at the L3-L4 level compressing the right nerve root. The patient was managed with L3-L4-L5 transpedicular fixation and right-side laminectomy L3-L4 for resection of the tumor. Histopathological examination confirmed the diagnosis of schwannoma. The patient had a favorable postoperative recovery and experienced a resolution of symptoms. Lumbar schwannomas are rare they can cause significant symptoms and require appropriate diagnosis and management. Microsurgery is the preferred treatment, and endoscopic microsurgery is the most promising technique.
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Affiliation(s)
| | | | - Renat Nurmukhametov
- Department of Neurosurgery, Peoples' Friendship University of Russia (RUDN University), Moscow, RUS
| | - Matias Baldoncini
- Laboratory of Microsurgical Neuroanatomy, School of Medicine, University of Buenos Aires, Buenos Aires, ARG
| | | | - Andreina Rosario
- Department of Anatomy, Autonomous University of Santo Domingo (UASD), Santo Domingo, DOM
| | - Yamaurys E Ogando
- Department of Neurological Surgery, Peoples' Friendship University of Russia (RUDN University), Moscow, RUS
| | - Karina M Ramirez
- Department of Neurological Surgery, Peoples' Friendship University of Russia (RUDN University), Moscow, RUS
| | - Jesus Lafuente
- Department of Neurological Surgery, Hospital Universitario del Mar, Barcelona, ESP
| | - Gennady E Chmutin
- Department of Neurosurgery, Peoples' Friendship University of Russia (RUDN University), Moscow, RUS
| | - Nicola Montemurro
- Department of Neurosurgery, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, ITA
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Saputra A, Sutikno J, Janitra R, Sufarnap E, Centery, Hasan RY, Satyanegara, Sumarsudi H, Siahaan FY, Boenjamin K. Giant lumbar schwannoma with retroperitoneal extension and vertebral body invasion: a case report. Pan Afr Med J 2023; 44:140. [PMID: 37333785 PMCID: PMC10276332 DOI: 10.11604/pamj.2023.44.140.37717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/13/2023] [Indexed: 12/19/2023] Open
Abstract
Schwannoma is a type of peripheral nerve sheath tumor derived from Schwann cells. There have been only a few cases of giant lumbar schwannoma with retroperitoneal extension eroding the vertebral body documented. Thus, managing these tumors presents various challenges. This paper reports a case of a 59-year-old woman who experienced lower back radicular pain for a year. A lumbar magnetic resonance imaging revealed the presence of a giant extradural soft tissue tumor measuring 8.6x7.4x9.7 cm, compressing the right L5-S1 neural foramen and extending into the retroperitoneal space while eroding the L5 vertebral body. The patient underwent surgery via a retroperitoneal approach, and the tumor was successfully resected. Histopathological examination confirmed the diagnosis of schwannoma. In conclusion, giant retroperitoneal lumbar schwannomas with bone invasion are rare, and gross total resection is the preferred treatment option, but the size and location of the tumor can make the surgery challenging.
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Affiliation(s)
- Angky Saputra
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | - Joshua Sutikno
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | - Raka Janitra
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | - Erliano Sufarnap
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | - Centery
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | | | - Satyanegara
- Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia
| | | | - Franky Yesaya Siahaan
- Thoracic and Cardiovascular Surgery Department, Mayapada Hospital, Tangerang, Indonesia
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Monawary SH, Zahid SU, Wardak K, Khan KS, Ullah I, Yousaf Z. Large lumbosacral schwannoma in a young female- a case report from Afghanistan. Ann Med Surg (Lond) 2022; 73:102986. [PMID: 34984098 PMCID: PMC8692994 DOI: 10.1016/j.amsu.2021.102986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/19/2021] [Accepted: 10/28/2021] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Mobile Schwannoma is a rare soft tissue tumor that commonly involves the elderly population. It has no cellular material and grows as solitary, firm, oval, encapsulated benign tumors from the sensory (dorsal) nerve root. If multiple, they are usually associated with Neurofibromatosis type 2 (NF-2). The initial sign and symptoms include segmental pain and paresthesia. It may lead to myelopathy if the tumor expands. CASE PRESENTATION We present a twenty-year-old female with chronic lower backache radiating to the ipsilateral thigh with no urinary or fecal incontinence. On physical examination, the ankle reflex was hypoactive on the left side, and the straight leg raise test was positive. A large 32 × 15 × 14 mm heterogeneous enhancing focal lesion was found on the posterior side of L5 and S1 vertebrae with severe central canal stenosis. A diagnosis of nerve sheath tumor was made based on contrast MRI pre-operatively. The underlying cause was a nerve sheath tumor. A total bilateral laminectomy at the L1-S5 level and mass excision was performed, preserving nerve roots. The postoperative period was uneventful, and no tumor re-growth was noticed. CLINICAL DISCUSSION Schwannoma is a slow-growing tumor; benign; usually, less than 8 cm in diameter tumor, commonly found in the head and neck region. It is the 3rd most common soft tissue tumor and the 2nd most common intradural extramedullary tumor. In our report, a young, non-Caucasian female patient is diagnosed with schwannoma, which is quite rare. In our case, a larger tumor of size 32 × 15 × 14 mm was noted, affecting the posterior body of L5 and S1 vertebrae in the left lateral recess with impingement of the left S1 traversing nerve root. Around 29% of spinal root nerve tumors are schwannomas. As the tumor grows slowly, the diagnosis may be delayed. CONCLUSION Schwannoma is a slow-growing solitary, firm, oval, encapsulated benign tumor arising from the sensory (dorsal) nerve root. Histopathology plays a vital role in diagnosis, and overall, the disease has a favorable prognosis. Therefore, an appropriate approach is necessary to rule out the disease.
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Affiliation(s)
| | | | - Kalimullah Wardak
- Department of Orthopedics and Traumatology, Wazir Mohammad Akbar Khan (WMAK) Hospital, Kabul, Afghanistan
| | - Kiran Shafiq Khan
- Dow Medical College, Dow University of Health Sciences, Karachi, 74200, Pakistan
| | - Irfan Ullah
- Kabir Medical College, Gandhara University, Peshawar, 25000, Pakistan
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Alshammari FA, Alotaibi AM, Alali MA, Alkhileiwi NS, Alshammari SM, Albagami MT, Alarimah YG, Aldughaim FA, Alsadady KA, Alshammari FF, Alhedires KM, Albejais NA, Alharbi MF, Alharthi AM, Alshammari M. Schwannoma: A Rare Etiology of Pancoast Syndrome. Cureus 2021; 13:e19418. [PMID: 34909333 PMCID: PMC8660959 DOI: 10.7759/cureus.19418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/05/2022] Open
Abstract
Musculoskeletal disorders represent a major public health problem and they are frequently managed in primary care centers. Shoulder pain is a frequent musculoskeletal complaint and it can result from intrinsic disorders of the shoulder or referred pain. We present the case of a 24-year-old woman who presented to the family medicine clinic complaining of left shoulder pain for three months duration. The pain was not associated with numbness or weakness. There was no history of preceding trauma. The initial diagnosis was supraspinatus tendinosis. The patient was prescribed oral analgesics and was advised to undergo multiple physiotherapy sessions. Later, the patient presented to the clinic again and reported she did not have any improvement in her symptoms. The patient was referred to the orthopedic clinic for further evaluation and management. The patient underwent a frontal radiograph of the chest which demonstrated a well-defined opacity located in the apex of the left lung. A computed tomography scan of the chest demonstrated the presence of erosion to the vertebral body raising the suspicion for a neurogenic tumor as was later supported by magnetic resonance imaging. The patient underwent video-assisted thoracotomy with brachial plexus exploration. Complete resection of the tumor was achieved with no complications. The present case highlights those common musculoskeletal complaints, such as shoulder pain, which could indicate underlying non-orthopedic pathology.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Noor A Albejais
- Family Medicine, Prince Saud Bin Jalawy Hospital, Al-Mubarraz, SAU
| | | | | | - Malak Alshammari
- Internal Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAU
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Giant retroperitoneal schwannoma removed with the laparoscopic approach: A case report. JOURNAL OF SURGERY AND MEDICINE 2021. [DOI: 10.28982/josam.874216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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