Cauda Equina Schwannoma Research Articles

Rostral migration of cauda equina schwannoma: Case report and literature review

A case of mobile schwannoma of the cauda equina migrating from L3 body to L2-L3 disc level in a period of 9 months is reported

Long-term recurrence after surgery for schwannoma of the cauda equina.

Background: Cauda equina tumors are rare primary spinal tumors. Histologically, the most common tumor arising from the cauda equina is a schwannoma. However, little is known about the long-term postoperative outcomes of cauda equina schwannoma. Here, we reviewed the median-to-long-term postoperative outcomes of eight of our own patients with schwannomas of the cauda equina.Methods: Between 2007 and 2020, we, retrospectively, reviewed eight patients with cauda equina schwannomas (CESs) undergoing nine operations at our institution. There were five males and three females averaging 56.5 years of age who were followed for over 40 postoperative months. The study included assessment of the following variables: the modified McCormick scale, tumor size, location, extent of resection, treatment of the tumor involving nerve roots, and postoperative observational follow-up.Results: Gross-total resection was achieved in all eight patients; none received adjuvant therapy. The involved nerve roots were completely sacrificed in seven patients and partially resected in one. During a median follow-up of 108 months, only one patient sustained a tumor recurrence 164 months following the index surgery.Conclusion: CESs may recur more than 10 years after the original surgery. Radical resection of the tumor, including complete removal of the involved nerve root during the index surgery, and long-term postoperative follow-up is, therefore, essential.

Tumor Occupation in the Spinal Canal and Clinical Symptoms of Cauda Equina Schwannoma: An Analysis of 22 Cases.

Study DesignRetrospective, radiological study.PurposeTo determine the relationship between clinical symptoms and the extent of tumor occupation of the spinal canal by cauda equina schwannoma.Overview of LiteratureLittle is known about the relationship between the size of tumors of the cauda equina and the manifestation of clinical symptoms. We analyzed this relationship by estimating the percentage of tumor occupation (PTO) in the spinal canal in cauda equina schwannomas and by correlating this parameter with the presence and severity of clinical symptoms.MethodsTwenty-two patients (9 men and 13 women; age, 19–79 years; mean age, 55.3 years) who were radiologically diagnosed with schwannomas of the cauda equina between April 2004 and July 2014 were retrospectively analyzed. PTO was measured in axial and sagittal magnetic resonance imaging slices in which the cross-sectional area of the tumor was the largest. Data regarding clinical symptoms and results of physical examinations were collected from patient medical records. PTO differences between symptom-positive and -negative groups were analyzed for each variable.ResultsIn the 4 cases in which tumor presence was not related to clinical symptoms, PTO was 5%–10% (mean, 9%) in axial slices and 23%–31% (mean, 30%) in sagittal slices. In the 18 cases in which symptoms were associated with the tumor, PTO was 11%–86% (mean, 50%) in axial slices and 43%–88% (mean, 71%) in sagittal slices. PTO in axial slices was significantly higher in the presence of Déjèrine symptoms and/or muscle weakness, a positive straight leg raise test, and a positive Kemp sign.ConclusionsPTO >20% in axial slices and >40% in sagittal slices can be an indication of symptomatic cauda equina schwannoma.

Giant Cauda Equina Schwannoma with Dystrophic Calcifications : Case Report and Review of the Literature

Giant spinal schwannoma of the cauda equine involving many nerve roots is rare, and ossification is usually not observed in the schwannoma. A 21-year-old man presented with a 12-month history of urinary dysfunction and numbness below the buttocks. Plain radiography showed scalloping of the posterior surface of the vertebral bodies from L4 to the sacrum, and magnetic resonance imaging and computed tomography revealed a giant cauda equina tumor with dystrophic calcification. The tumor was completely removed, with intraoperative neurophysiologic monitoring. Histopathologic examination showed that the tumor was a schwannoma. The patient's postoperative course was uneventful, with urinary function and numbness gradually improving. Although a giant schwannoma accompanied by dystrophic calcification is extremely rare, such a tumor can be removed safely and completely by meticulous dissection and careful neuromonitoring of the cauda equina spinal nerves involved in the tumor.

Concurrent schwannoma and intradural neuroma after resection of a cauda equina schwannoma. A case report and first description

We present the case of a 33-year-old female complaining of recurrent pain and sensory disturbance in both legs, 3 years after the removal of a schwannoma at the level of L2/3. Magnetic resonance imaging showed two lesions at the site of the previous operation. Assuming tumour recurrence, the patient was referred for surgery. Intraoperatively, both an intradural neuroma and a schwannoma were found. Histopathological assessment confirmed the diagnosis of both coexisting entities. Neuroma should be considered in the differential diagnosis of spinal lesions, particularly in the assumption of recurrence.

A long-segment string of bead-like schwannoma of cauda equina: a case report

Spinal schwannomas are one of the most common intradural extramedullary spinal tumors. However, a string of bead-like intradural extramedullary schwannoma is highly uncommon. In the paper we present a case of a long-segment string of bead-like intradural extramedullary schwannoma of cauda equina from L2 to S2.The patient had been suffering progressive low back pain and sciatica with progressive neurological deficits for three years. She was misdiagnosed as lumbar disc herniation at her first time of hospitalization after a simple lumbar computed tomography (CT) scanning and a discectomy. We found her tumor by magnetic resonance imaging (MRI) and totally removed it. We therefore emphasize differentiating this almost completely curable tumor from other lumbar diseases such as lumbar disc herniation. It is suggested that a reasonable and careful strategy of surgery for these tumors is important.

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

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.

Spinal arteriovenous fistulae with a concomitant cauda equina schwannoma

Background Perimedullary spinal arteriovenous malformations or direct spinal arteriovenous fistulaes (AVFs) may be associated with other vascular abnormalities, such as arteriovenous malformations, venous ectasis, and aneurysms, but rarely have been reported with intraspinal intradural tumors. Purpose The authors present an interesting case of type IV-A spinal AVF concomitant with a cauda equina schwannoma. Study design The diagnostic procedures and surgical outcome were described. Methods The patient underwent surgery, the vessel feeding the AVFs was identified and cauterized, and the spinal tumor was removed. The fistula was small and located inside the tumor. The pathology revealed AVF and schwannoma, respectively. Results After surgery, the patient's symptoms began to improve and subside. Two years after surgery, follow-up magnetic resonance imaging showed no vascular lesion and tumor in the spinal canal. Conclusions The association of spinal AVFs and cauda equina schwannoma has not been reported previously in any literature. The patient presents the symptoms of myelopathy associated with a spinal vascular lesion; it has to be noted that a concomitant and related intradural spinal tumor may exist.

馬尾に発生した小児悪性神経鞘腫の１例

A case of malignant schwannoma arising in the cauda equina is presented. The patient was a 4-year-old boy who began to experience pain in the left popliteal fossa without a clear cause. Spinal neoplasm was suspected after MRI and urinary dysfunction deteriorated. We performed immediate tumor resection. The space occupying lesion in the lumbar canal was diagnosed as malignant schwannoma of cauda equina histologically. Though he underwent chemotherapy after surgery, the tumor recurred seven months later. Adjuvant radiation therapy was performed, and although the size of the lesion reduced in MRI, additional metastatic lesion was found in the thoracic spine and brain. Although malignant schwannoma of cauda equina is very rare in childhood, spine surgeons should pay attention to this pathology because of the difficulty involved in treating it.

Cauda Equina Schwannoma Misdiagnosed as Focal Motor Neuron Disease

Cauda Equina Schwannoma Misdiagnosed as Focal Motor Neuron Disease

Mobile schwannoma of the cauda equina diagnosed by magnetic resonance imaging.

Three cases of a mobile cauda equina schwannoma, preoperatively diagnosed by magnetic resonance imaging, are described. When dealing with tumors of the cauda equina, it is important to carry out a second magnetic resonance imaging scan after changes in posture, bearing in mind the possibility of mobility of the tumor.

Mobile Schwannoma of the Cauda Equina Diagnosed by Magnetic Resonance Imaging

Abstract Three cases of a mobile cauda equina schwannoma, preoperatively diagnosed by magnetic resonance imaging, are described. When dealing with tumors of the cauda equina, it is important to carry out a second magnetic resonance imaging scan after changes in posture, bearing in mind the possibility of mobility of the tumor.