Neurosurgery Department, Mayapada Hospital, Tangerang, Indonesia.
General Surgery Department, Mayapada Hospital, Tangerang, Indonesia.
Pan Afr Med J. 2023 Mar 17;44:140. doi: 10.11604/pamj.2023.44.140.37717. eCollection 2023.
Schwannoma is a type of peripheral nerve sheath tumor derived from Schwann cells. There have been only a few cases of giant lumbar schwannoma with retroperitoneal extension eroding the vertebral body documented. Thus, managing these tumors presents various challenges. This paper reports a case of a 59-year-old woman who experienced lower back radicular pain for a year. A lumbar magnetic resonance imaging revealed the presence of a giant extradural soft tissue tumor measuring 8.6x7.4x9.7 cm, compressing the right L5-S1 neural foramen and extending into the retroperitoneal space while eroding the L5 vertebral body. The patient underwent surgery via a retroperitoneal approach, and the tumor was successfully resected. Histopathological examination confirmed the diagnosis of schwannoma. In conclusion, giant retroperitoneal lumbar schwannomas with bone invasion are rare, and gross total resection is the preferred treatment option, but the size and location of the tumor can make the surgery challenging.
神经鞘瘤是一种源自施万细胞的周围神经鞘肿瘤。仅有少数几例巨大的腰椎神经鞘瘤伴有腹膜后延伸侵蚀椎体的病例被报道。因此,这些肿瘤的治疗存在各种挑战。本文报告了一例 59 岁女性患者,其经历了一年的下背部神经根痛。腰椎磁共振成像显示存在一个 8.6x7.4x9.7cm 的巨大硬脊膜外软组织肿瘤,压迫右侧 L5-S1 神经孔并延伸至腹膜后间隙,同时侵蚀 L5 椎体。患者通过腹膜后入路进行了手术,肿瘤被成功切除。组织病理学检查证实了神经鞘瘤的诊断。总之,巨大的腹膜后腰椎神经鞘瘤伴骨侵犯较为罕见,广泛全切除是首选治疗方法,但肿瘤的大小和位置可能使手术具有挑战性。