Intramedullary schwannoma of the cervical spinal cord

Abstract

Summary Intramedullary spinal schwannoma is rare. Here, we report the case of a patient with solitary cervical intramedullary schwannoma that was detected by magnetic resonance imaging (MRI) and treated with total surgical resection. We have also reviewed similar cases reported in the literature. Our patient was a 44-year-old male tennis coach who presented with clumsiness, numbness, and weakness in all four limbs for 2 years. He exhibited Hoffman's sign and Lhermitte's sign, and showed sensory impairment below the C4 level and increased deep tendon reflexes; the muscle power of all four limbs was grade 4. MRI showed an intramedullary lesion with homogeneous enhancement at the C5–C6 level, approximately 3.6 cm in its greatest diameter. He underwent total resection of the tumor. Histopathological findings were consistent with the diagnosis of a benign schwannoma. The postoperative course was uneventful, and the patient was discharged without any change in his neurological status, apart from improvement in the strength of both his upper limbs. Intramedullary spinal schwannoma, although rare, is a benign tumor and, unlike intramedullary ependymoma and astrocytoma, can be cured by surgical treatment. Gross total resection can be achieved with minimal risks and a good clinical outcome.