[Two different spinal tumors (meningioma and schwannoma) with von Recklinghausen's disease in a case].

Von Recklinghausen's neurofibromatosis is a congenital anomaly due to maldevelopment of the neurectoderm and mesoderm. The disease is known to be commonly associated with other tumors of the neural system. We experienced a case in which two different types of spinal tumors (meningioma and schwannoma) appeared together with Von Recklinghausen's disease. The patient was a 54 year-old female. Her chief complaint was slowly progressive lumbar back pain of about a 10-year duration. She was admitted to our hospital after developing such clinical symptoms as paraparesis, bladder and rectal incontinence, and pain in the soles of her feet. The CT study demonstrated a massive tumor at the TH12-L2 levels accompanied with marked scalloping of the posterior vertebral body. The tumor removed was, histologically, meningioma. During surgery, another small bean-size tumor was incidentally found originating from the dorsal root, and it was identified by histological study as typical schwannoma. It has been reported that the incidence rate of spinal tumors in von Recklinghausen's disease is approximately 4%. Although a case has been reported in which different types of tumors developed in both the cranium and the spinal canal, our case as described above is considered extremely rare as far as we can find in reference literature. The pathogenic mechanism of vertebral scalloping as encountered in our case was thought to be based on interactions between hypoplasia of the supporting tissue and pressure generated by the tumor and CSF.