Abstract
INTRODUCTION: Ancient schwannomas are rare encapsulated tumours that derive from the nerve sheath and should be removed due to their infrequent but existent possibility of malignancy. CASE PRESENTATION: We report a case of a mass located in the L4 lumbar spine in a 50 year old woman who presented with low back ache since 6 months. Ultrasound, CT and MRI were used to examine the characteristics of the lesion. Fine needle aspiration showed cytological characteristics of a benign schwannoma and final histological diagnosis was an Ancient schwannoma. A posterior approach, through a left paraspinal incision was used to approach the site of the mass. The lesion originated from a branch of the L4 nerve root of the L4-L5 lumbar spinal space and a complete excision was achieved, preserving the nerve. CONCLUSION: Paraspinal tumours can be benign to most aggressive lesions. It is therefore a necessity for the surgeon to understand the pathology preoperatively by a MRI and FNAC, to avoid overtreatment and major complications.
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