圆锥部髓内神经鞘瘤1例罕见病例：病例报告并文献复习
A rare case of intramedullary schwannoma at conus medullaris: A case report with review of literature.
作者信息
Varshney Rahul, Bharadwaj Pranjal, Choudhary Ajay, Paliwal Purnima, Kaushik Kaviraj
机构信息
Department of Neurosurgery, Dr. RML Hospital, New Delhi, India.
Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences and RML Hospital, New Delhi, India.
出版信息
Surg Neurol Int. 2020 Dec 22;11:454. doi: 10.25259/SNI_718_2020. eCollection 2020.
BACKGROUND
Intramedullary spinal schwannomas constitute only 0.3% of primary spine tumors. We could identify only 13 such cases involving the conus that were not associated with neurofibromatosis (NF). Here, we report a 70-year-old male without NF who was found to have a paraparesis due to a schwannoma of the thoracolumbar junction/conus (D11-L2).
CASE DESCRIPTION
A 70-year-old male presented with an L1-level paraparesis with urinary incontinence. The magnetic resonance showed an intramedullary mass of 85 × 10 mm extending from D11 to L2; it demonstrated significant patchy enhancement. The patient underwent a D12 and L1 laminectomy with gross total excision of the mass that proved to be a schwannoma. Three months postoperatively, he was able to ambulate with support, and regained sphincter function.
CONCLUSION
Intramedullary schwannomas involving the conus/thoracolumbar junction are rare, and can be successfully excised resulting in good outcomes.
背景
脊髓内神经鞘瘤仅占原发性脊柱肿瘤的0.3%。我们仅能识别出13例累及圆锥且与神经纤维瘤病（NF）无关的此类病例。在此，我们报告一例70岁无NF的男性，其因胸腰段交界处/圆锥（D11-L2）神经鞘瘤导致双下肢轻瘫。
病例描述
一名70岁男性出现L1水平双下肢轻瘫伴尿失禁。磁共振成像显示一个从D11延伸至L2的85×10mm髓内肿块；其表现为明显的斑片状强化。患者接受了D12和L1椎板切除术，肿块被完整切除，病理证实为神经鞘瘤。术后三个月，他能够在辅助下行走，并恢复了括约肌功能。
结论
累及圆锥/胸腰段交界处的脊髓内神经鞘瘤罕见，可成功切除并取得良好预后。
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