Monawary Sayed Hanif, Zahid Shafi Ullah, Wardak Kalimullah, Khan Kiran Shafiq, Ullah Irfan, Yousaf Zohaib
Department of Neurosurgery, Jamhuriat Hospital, Kabul, Afghanistan.
Department of Orthopedics and Traumatology, Wazir Mohammad Akbar Khan (WMAK) Hospital, Kabul, Afghanistan.
Ann Med Surg (Lond). 2021 Oct 30;73:102986. doi: 10.1016/j.amsu.2021.102986. eCollection 2022 Jan.
Mobile Schwannoma is a rare soft tissue tumor that commonly involves the elderly population. It has no cellular material and grows as solitary, firm, oval, encapsulated benign tumors from the sensory (dorsal) nerve root. If multiple, they are usually associated with Neurofibromatosis type 2 (NF-2). The initial sign and symptoms include segmental pain and paresthesia. It may lead to myelopathy if the tumor expands.
We present a twenty-year-old female with chronic lower backache radiating to the ipsilateral thigh with no urinary or fecal incontinence. On physical examination, the ankle reflex was hypoactive on the left side, and the straight leg raise test was positive. A large 32 × 15 × 14 mm heterogeneous enhancing focal lesion was found on the posterior side of L5 and S1 vertebrae with severe central canal stenosis. A diagnosis of nerve sheath tumor was made based on contrast MRI pre-operatively. The underlying cause was a nerve sheath tumor. A total bilateral laminectomy at the L1-S5 level and mass excision was performed, preserving nerve roots. The postoperative period was uneventful, and no tumor re-growth was noticed.
Schwannoma is a slow-growing tumor; benign; usually, less than 8 cm in diameter tumor, commonly found in the head and neck region. It is the 3rd most common soft tissue tumor and the 2nd most common intradural extramedullary tumor. In our report, a young, non-Caucasian female patient is diagnosed with schwannoma, which is quite rare. In our case, a larger tumor of size 32 × 15 × 14 mm was noted, affecting the posterior body of L5 and S1 vertebrae in the left lateral recess with impingement of the left S1 traversing nerve root. Around 29% of spinal root nerve tumors are schwannomas. As the tumor grows slowly, the diagnosis may be delayed.
Schwannoma is a slow-growing solitary, firm, oval, encapsulated benign tumor arising from the sensory (dorsal) nerve root. Histopathology plays a vital role in diagnosis, and overall, the disease has a favorable prognosis. Therefore, an appropriate approach is necessary to rule out the disease.
移动性神经鞘瘤是一种罕见的软组织肿瘤，常见于老年人群。它没有细胞物质，作为孤立的、质地坚实的、椭圆形的、有包膜的良性肿瘤从感觉（背侧）神经根生长而来。如果是多发的，通常与2型神经纤维瘤病（NF - 2）相关。最初的症状包括节段性疼痛和感觉异常。如果肿瘤扩大，可能会导致脊髓病。
我们报告一名20岁女性，有慢性下背痛并放射至同侧大腿，无大小便失禁。体格检查发现左侧踝反射减弱，直腿抬高试验阳性。在L5和S1椎体后侧发现一个大小为32×15×14mm的巨大不均匀强化局灶性病变，伴有严重的中央管狭窄。术前通过增强磁共振成像诊断为神经鞘瘤。病因是神经鞘瘤。在L1 - S5水平进行了双侧全椎板切除术并切除肿块，保留神经根。术后恢复顺利，未发现肿瘤复发。
神经鞘瘤是一种生长缓慢的肿瘤；良性；通常直径小于8cm，常见于头颈部区域。它是第三常见的软组织肿瘤和第二常见的硬膜内髓外肿瘤。在我们的报告中，一名年轻的非白种女性患者被诊断为神经鞘瘤，这相当罕见。在我们的病例中，发现了一个较大的肿瘤，大小为32×15×14mm，并影响左侧侧隐窝的L5和S1椎体后缘，压迫左侧S1横过神经根。约29%的脊神经根肿瘤是神经鞘瘤。由于肿瘤生长缓慢，诊断可能会延迟。
神经鞘瘤是一种生长缓慢的孤立的、质地坚实的、椭圆形的、有包膜的良性肿瘤，起源于感觉（背侧）神经根。组织病理学在诊断中起着至关重要的作用，总体而言，该疾病预后良好。因此，需要采取适当的方法来排除该疾病。
