Abstract
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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References
Borges G, Bonilha L, Proa JrM, Fernandes YB, Ramina R, Zanardi V, et al. Imaging features and treatment of an intradural lumbar cystic schwannomaI. Arq Neuropsiquiatr. 2005;63:681–4.
Santhosh K, Kesavadas C, Thomas B, Gupta AK, Kapilamoorthy TR, Radhakrishnan V. Fluid-fluid levels in cystic lumbosacral schwannomas: a report of three cases. Singap Med J. 2009;50:16–21.
Jaiswal A, Shetty AP, Rajasekaran S. Giant cystic intradural schwannoma in the lumbosacral region: a case report. J Orthop Surg. 2008;16:102–6.
Kasliwal MK, Kale SS, Sharma BS, Suri V. Totally cystic intradural extramedullary schwannoma. Turkish Neurosurg 2008;18:404–6.
Parmar H, Patkar D, Gadani S, Shah J. Cystic lumbar nerve sheath tumours: MRI features in five patients. Australas Radiol. 2001;45:123–7.
Karatas A, IS M, Yildirim U, Akyuz F, Gezen F. Thoracic intradural cyst schwannoma: a case report. Turkish Neurosurg. 2007;17:193–6.
Vikram M, Pande A, Vasudevan MC, Ravi R. Cervical solitary long segment cystic Schwannoma. Br J Neurosurg. 2010;24:208–10.
Conti P, Pansini G, Mouchaty H, Capuano C, Conti R. Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol. 2004;61:35–44.
Kumar S, Gupta R, Handa A, Sinha R. Totally cystic intradural schwannoma in thoracic region. Asian J Neurosurg. 2017;12:131–3.
Savardekar A, Singla N, Mohindra S, Ahuja CK, Gupta SK. Cystic spinal schwannomas: a short series of six cases. Can we predict them preoperatively? Surg Neurol Int. 2014;5:S349–53.
Netra R, Hui MS, Gang MZ, Ming Z. Spinal cystic schwannoma: an MRI evaluation. J Coll Physicians Surg Pak. 2014;24:145–7.
Hsieh C, Tsai W, Liu M. Intradural lumbar cystic schwannoma. Neuroscience (Riyadh). 2011;16:366–8.
Himmiche M, Benzagmout M, Alami B, Benabdellah IS, Chakour K, Chaoui ME. Giant cystic schwannoma of the cauda equina. Ann Afr Med. 2019;18:180–3.
Akhaddar A, Ajja A, Albouzidi A, Elmostarchi B, Boucetta M. A cystic schwannoma of the cauda equina mimicking hemangioblastoma. Neurochirurgie. 2008;54:101–3.
Attiah MA, Syre PP, Pierce J, Belyaeva E, Welch WC. Giant cystic sacral schwannoma mimicking tarlov cyst: a case report. Eur Spine J 2016;25:84–88.
Sakamoto M, Harayama K, Furufu T. A case of cystic spinal schwannoma presented unusual clinical findings. Orthopedics 1985;3:1185–9.
Enzinger FM. Schwannomas. In: Harshberger, SE, editor. Soft tissue tumors. St Louis:Mosby; 1983. p. 585–97.
Albert AF, Kirkman MA, Plessis D, Sacho R, Cowie R, Tzerakis NG. Giant solitary cystic schwannoma of the cervical spine: a case report. Clin Neurol Neurosurg. 2012;114:396–8.
Desheng WU, Zhaoyu BA, Huang Y, Zhao W, Shen B, Kan H. Totally cystic schwannoma of the lumbar spine. Orthopedics 2013;5:679–82. (36)
Suzuki H, Yamaguchi Y, Kimura H, Shiba M, Baba M, Hiroshima K. Malignant mediastinal schwannoma associated with von Recklinghausen’s disease – a resected case. Nippon Kyobu Geke Gakkai Zaoshi. 1996;44:864–8.
Vilanova JC, Dolz JL, Maestro de Leon JL. MR imaging of a malignant schwannoma and an osteoblastoma with fluid-fluid levels. Report of two new cases. Eur Radio. 1998;8:1359–62.
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Samman, A.M., Bardeesi, A.M. & Alzahrani, M.T. Thoracic cystic schwannoma: case report and review of literature. Spinal Cord Ser Cases 7, 7 (2021). https://doi.org/10.1038/s41394-020-00376-0
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DOI: https://doi.org/10.1038/s41394-020-00376-0
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