Antonopoulos Constantine, Lilimpakis Constantine, Karagianni Maria, Daskalopoulou Dimitra, Kyriakou Theodoulos, Vagianos Constantine
Department of Surgery, Nikea General Hospital, 3D Mantouvalos St, Nikea Pireus, 18454, Greece.
Cases J. 2009 Dec 15;2:9325. doi: 10.1186/1757-1626-2-9325.
Schwannomas are rare encapsulated tumors that derive from the nerve sheath and should be removed due to their infrequent, but existent possibility of malignancy.
We report a case of a mass located in the L5 lumbar spine in a 42 year old man, presented with intermittent lumbar pain. Ultrasound, CT and MRI were used to examine the characteristics of the lesion. Fine needle aspiration showed cytologic characteristics of benign schwannoma and final histological diagnosis was ancient schwannoma. An extraperitoneal approach, through a left paramedian incision was used to approach the site of the mass. The lesion originated from the nerve root of the L4-L5 lumbar spinal space and a complete excision was achieved.
A great variety of tumors should be differentiated when a paraspinal mass is discovered, including neurogenic, neuroendocrine and vascular tumors, as well as malignancies, cystic and inflammatory masses. Fine needle aspiration is a useful and reliable tool in the preoperative evaluation of paraspinal masses. A review of the literature is also presented.
施万细胞瘤是一种罕见的包膜肿瘤，起源于神经鞘膜，因其恶变可能性虽小但存在，故应予以切除。
我们报告一例42岁男性患者，其L5腰椎处有一肿块，表现为间歇性腰痛。采用超声、CT和MRI检查病变特征。细针穿刺显示为良性施万细胞瘤的细胞学特征，最终组织学诊断为陈旧性施万细胞瘤。通过左旁正中切口经腹膜外途径接近肿块部位。病变起源于L4-L5腰椎间隙神经根，已完整切除。
发现椎旁肿块时，应鉴别多种肿瘤，包括神经源性、神经内分泌性和血管性肿瘤，以及恶性肿瘤、囊性和炎性肿块。细针穿刺是椎旁肿块术前评估的一种有用且可靠的工具。本文还对相关文献进行了综述。
