Kaohsiung Journal of Medical Sciences
Volume 24, Issue 4 , Pages 212-217, April 2008

Giant Invasive Schwannoma of Cauda Equina with Minimal Neurologic Deficit: A Case Report and Literature Review

  • Chen-Hsiang Hung

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Tai-Hsin Tsai

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • ,
  • Ann-Shung Lieu

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • Corresponding Author InformationAddress correspondence and reprint requests to: Dr Ann-Shung Lieu, Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, 100 Tzyou 1st Road, Kaohsiung 807, Taiwan
    • ,
  • Chih-Lung Lin

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Kung-Shing Lee

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Shiuh-Lin Hwang

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
    • ,
  • Shen-Long Howng

      Affiliations

    • Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
    • Department of Surgery, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

Received 12 April 2007; accepted 11 July 2007.

Article Outline

A 53-year-old man presented with a history of slight weakness in the right lower limb. Giant invasive cauda equina schwannoma was diagnosed according to the criteria of Sridhar et al. Schwannomas are usually benign and common tumors arising from nerve sheath cells, particularly from sensory nerves. Giant invasive schwannomas, however, are rare, and most of patients with them present with severe neurologic deficits independent of daily activity, although in the case presented here, in spite of the large size of the tumor causing pedicle erosion, expansive destruction of the vertebral body and widening of the neural foramina, there were only minimal neurologic deficits. We have therefore decided to report this case, with a review of the relevant English literature emphasizing clinical presentations, plain film images and magnetic resonance image findings of giant invasive cauda equina schwannoma for early diagnosis and differential diagnosis.

Key Words:  cauda equina , giant invasive schwannoma

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Singrakhia MD , Parmar H , Maheshwari M , et al.   Cervical schwannoma presenting as an expansile vertebral body lesion: report of two cases with a technical note on the surgical management . Surg Neurol . 2006;66:192–196
  2. Inaoka T , Takahashi K , Hanaoka H , et al.   Paravertebral neurinoma associated with aggressive intravertebral extension . Skeletal Radiol . 2001;30:286–289
  3. Pamasamy P , Shackleford I , Jafari M . Schwannoma of T12 vertebra: case report and review of literature . Sarcoma . 2000;4:185–190
  4. Conti P , Pansini G , Mouchaty H , et al.   Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature . Surg Neurol . 2004;61:35–44
  5. Van Goethem JW , van den Hauwe L , Ozsarlak O , et al.   Spinal tumors . Eur J Radiol . 2004;50:159–176
  6. Wager M , Lapirerre F , Blanc JL , et al.   Cauda equina tumors: a French multicenter retrospective review of 231 adult cases and review literature . Neurosurg Rev . 2000;23:119–129
  7. Kagaya H , Abe E , Sato K . Giant cauda equina schwannoma: a case report . Spine . 2000;25:268–272
  8. Saito T , Shimode M , Azuma S , et al.   Giant schwannoma of the cauda equina with dural ectasia: a case report . J Orthop Sci . 2004;9:635–637
  9. Natarajan M , Rajagopal T , Srinivasan K . A giant schwannoma of cauda equine . Surg Neurol . 1975;4:367–368
  10. Iwasaki M , Nakamura K , Takeshita K , et al.   Surgical management of giant schwannoma in the lumosacral region . J Spinal Disord . 1998;11:444–447
  11. Osborn RE , DeWitt JD . Giant cauda equine schwannoma: CT appearance . AJNR Am J Neuroradiol . 1985;6:835–836
  12. Sridhar K , Ramamurthi R , Vasudevan MC , et al.   Giant invasive spinal schwannomas: definition and surgical management . J Neurosurg . 2001;94:210–215
  13. Shimada Y , Miyakoshi N , Kasukawa Y , et al.   Clinical features of cauda equina tumors requiring surgical treatment . Tohoku J Exp Med . 2006;209:1–6

PII: S1607-551X(08)70120-7

doi:10.1016/S1607-551X(08)70120-7

Kaohsiung Journal of Medical Sciences
Volume 24, Issue 4 , Pages 212-217, April 2008

Article Tools