Abstract
OBJECTIVE: To describe a unique clinical presentation and rapid recurrence of cervical Schwannoma. BACKGROUND: Schwannomas are known to be benign peripheral nerve tumors, 25% of the cases occur in the head and neck region and are frequently ( 18%) associated with NF -2 with recurrence rates (5%) after subtotal resection. CASE DESCRIPTION: 16 year-old right-handed female presented to the ED for right arm and leg weakness, right foot drop, patchy paresthesias after a fall five months prior to the presentation. Physical exam revealed absence of neurocutaneous markers, subtle right arm and leg weakness, hand apraxia, hyperreflexia, high steppage gait with right-sided ataxia. Outpatient Brain and Lumbar MRI prior to presentation were reported normal. Patient underwent cervical MRI with and without contrast in ED, which revealed a dumbbell lesion, expanding the right neural foramina at C6-C7 and severe central spinal stenosis with cord compression. She received IV dexamethasone and subsequently underwent subtotal resection of a right C7 schwannoma with posterior cervicothoracic instrumentation. Genetics consultation suggested NF-2, given family history of cervical schwannoma in paternal uncle. RESULTS: Surgical pathology revealed WHO grade I schwannoma. Patient was discharged home with short interval follow-up showing resolution of her right upper extremity weakness. MRI c-spine, 6 weeks post-op, revealed regrowth of the schwannoma through the neural foramen at C6-7. NF-2 work-up pending. DISCUSSION: Schwannomas may present in an acute setting in a variety of ways despite an absence of cutaneous findings. Imaging of the total spine should be performed in a timely manner, preferentially MRI with and without contrast, in suspected cases. Surgical resection is preferred to spare permanent neurologic impairment. Gross total resections have been associated with better outcomes. Short interval follow up is suggested for patients with subtotal resection.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
