Rosyidi Rohadi Muhammad, Wardhana Dewa Putu Wisnu, Priyanto Bambang, Gunawan Kevin
Department of Neurosurgery, Medical Faculty of Mataram University, West Nusa Tenggara General Hospital, Mataram, Indonesia.
Department of Neurosurgery, Udayana University Hospital, Medical Faculty of Udayana University, Bali, Indonesia.
Ann Med Surg (Lond). 2022 Aug 5;80:104306. doi: 10.1016/j.amsu.2022.104306. eCollection 2022 Aug.
and importance. Schwannomas are benign tumors that often occur in the medulla spinalis. It arises from the Schwann cells which form the sheath of peripheral nerves. Schwannomas comprise about 30% of primary intraspinal neoplasms and approximately 75% in intradural, 10% intra-extradural, and 15% extradural. Purely extradural schwannoma is rare.
We present two adult males with extradural thoracal schwannoma. In this case, the main complaint is paraparesis and followed by suffered low back pain and spastic. The initial symptoms of this tumor depend on the level of the tumor location. Usually begins with localized pain, sharp and transient, followed by radicular pain and radiculopathy. We reported cases of schwannoma of the thoracal spine that have presented with neurological involvement. As a result of contrast, an MRI of the spine showed tumor extradural mass lesion extending from thoracal 1-2 vertebral and thoracal 4-6 vertebral level.
The location of this tumor is rare because located in the extradural (15%), which are present between the bone structure and the dura. Surgery is the treatment of choice, in this case, usually results from excellent prognostic. This patient underwent hemilaminectomy and complete surgical resection.
Early diagnostic and complete surgical resection before the occurrence of severe symptoms will show an excellent prognosis.
雪旺瘤是一种常见于脊髓的良性肿瘤。它起源于构成周围神经鞘的雪旺细胞。雪旺瘤约占原发性脊柱内肿瘤的30%,其中约75%位于硬膜内,10%位于硬膜内外,15%位于硬膜外。单纯硬膜外雪旺瘤较为罕见。
我们报告了两名患有硬膜外胸段雪旺瘤的成年男性。在此病例中,主要症状是双下肢轻瘫,随后出现腰痛和痉挛。该肿瘤的初始症状取决于肿瘤所在位置的水平。通常始于局部疼痛,尖锐且短暂,随后出现神经根性疼痛和神经根病。我们报告了胸段脊柱雪旺瘤伴有神经受累的病例。经造影后,脊柱磁共振成像显示肿瘤为硬膜外肿块病变,从胸1 - 2椎体及胸4 - 6椎体水平延伸。
该肿瘤的位置较为罕见,因为它位于硬膜外(15%),处于骨结构和硬脑膜之间。手术是首选治疗方法,在此病例中,通常预后良好。该患者接受了半椎板切除术及完整的手术切除。
在出现严重症状之前进行早期诊断并完整切除肿瘤,预后良好。