Hayashi Fumio, Sakai Toshinori, Sairyo Koichi, Hirohashi Nori, Higashino Kosaku, Katoh Shinsuke, Yasui Natsuo
Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Spine J. 2009 May;9(5):e19-23. doi: 10.1016/j.spinee.2008.11.006. Epub 2009 Jan 9.
There have been few reports on intramedullary ancient schwannoma. Schwann cells are generally present in the nerve root, not in the spinal cord. Thus, intramedullary schwannomas are rare, and in most cases there is cyst formation without calcification.
To report a patient with intramedullary ancient schwannoma at the epiconus together with a review of the previously published cases.
Case report.
A 78-year-old woman.
Retrospective case review.
A 78-year-old woman had presented with severe weakness of the lower extremities, increased patellar reflex, and sensory disturbance of the entire lower extremities. Magnetic resonance imaging showed a tumorous mass in the intramedullary region of epiconus at T11-L1, and computed tomography revealed calcification in the tumor. She underwent total resection of the tumor. Histopathological findings were consistent with the diagnosis of ancient schwannoma. After the operation, although lower extremities weakness and sensory disturbance deteriorated transiently, lower leg pain disappeared. At the final follow-up of 10 months after the operation, lower leg pain did not relapse.
We reported a rare case presenting epiconus syndrome due to intramedullary ancient schwannoma, which should be considered for the differential diagnosis of a tumor that shows calcification.
关于髓内陈旧性神经鞘瘤的报道较少。雪旺细胞通常存在于神经根,而非脊髓。因此,髓内神经鞘瘤较为罕见,且在大多数情况下会形成囊肿,无钙化表现。
报告1例圆锥部髓内陈旧性神经鞘瘤患者,并对既往发表的病例进行回顾。
病例报告。
一名78岁女性。
回顾性病例分析。
一名78岁女性,表现为下肢严重无力、髌反射亢进及双下肢感觉障碍。磁共振成像显示T11-L1水平圆锥髓内区域有一肿瘤性肿块,计算机断层扫描显示肿瘤内有钙化。患者接受了肿瘤全切术。组织病理学检查结果符合陈旧性神经鞘瘤的诊断。术后,尽管下肢无力和感觉障碍短暂加重,但小腿疼痛消失。术后10个月的最后随访时,小腿疼痛未复发。
我们报告了1例因髓内陈旧性神经鞘瘤导致圆锥综合征的罕见病例,对于表现为钙化的肿瘤,应考虑将其纳入鉴别诊断。