Jaiswal A, Shetty A P, Rajasekaran S
Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India.
J Orthop Surg (Hong Kong). 2008 Apr;16(1):102-6. doi: 10.1177/230949900801600124.
We report a case of a giant cystic intradural schwannoma of the lumbosacral region in a 30- year-old man who presented with a 2-year history of non-specific lower back pain. Lateral radiographs demonstrated scalloping of the posterior wall of L5 and the upper sacrum. Magnetic resonance imaging revealed a 12 x 2.3-cm intradural multi-septated cystic lesion extending from L3 to S2 with predominant hypointense signal on T1-weighted images and a mixed signal on T2-weighted images. There was heterogeneous rim enhancement of the retrosacral portion of lesions following the administration of gadolinium contrast. The tumour was completely excised. Histological investigation confirmed the diagnosis of cystic schwannoma with alternating hypercellular (Antoni A) and hypocellular (Antoni B) areas in a fibrillar background. The patient had complete relief of symptoms and remained asymptomatic after 2 years of follow-up.
我们报告一例30岁男性腰骶部巨大囊性硬膜内神经鞘瘤病例,该患者有2年非特异性下背痛病史。腰椎侧位X线片显示L5和上骶骨后壁呈扇贝样改变。磁共振成像显示一个12×2.3 cm的硬膜内多房囊性病变,从L3延伸至S2,在T1加权图像上主要为低信号,在T2加权图像上为混合信号。给予钆对比剂后,病变骶后部分有不均匀边缘强化。肿瘤被完全切除。组织学检查证实为囊性神经鞘瘤,在纤维背景中有交替的高细胞区(Antoni A)和低细胞区(Antoni B)。患者症状完全缓解,随访2年后仍无症状。