[An autopsy case of malignant schwannoma in the brachial plexus extending into the spinal canal].

A 40-year-old woman had pain and numbness in the left upper extremity, on Dec. 1982. These symptoms progressed gradually. She was admitted to our department on Jan. 26, 1984 because of neck pains and progressive paraplegia. Neurological examination revealed monoplegia of the left arm with absent DTRs, spastic paraplegia, sensory disturbances below Th 11 level and severe sphincter disturbance. A metrizamide myelogram showed intradural extramedullary mass at C 4-7. Laminectomy was immediately performed from C 3 to C 7. A soft and brown tumor was attached at the ventral aspect of the cord at C 3 and C 7 and it was firmly attached at the root sleeve of the C 5 level. The histological diagnosis of the tumor was malignant schwannoma. One month later, she was discharged on foot. However, she was re-admitted to our department because of intractable pains in left neck and arm in Aug. '84. The second operation was done on Sept. 15. A soft and brown mass was found intra- and extradurally and it invaded into paravertebral muscules. On Sep. 30 '84 she died from respiratory failure. Postmortem examination revealed that intra-extradural tumor was found at C 4-Th 3, and the left brachial plexus was swollen. In the brachial plexus, the nerve fiber was replaced with tumor in the perineurium. The tumor invaded to the vertebral body and the paravertebral muscles. There were numerous metastasis of the tumor in both lungs. The tumor was formed by variable and scanty cytoplasm with many mitotic figures.(ABSTRACT TRUNCATED AT 250 WORDS)