Thoracic Schwannoma in an Adult Male Presenting With Thoracic Pain: A Case Report.

OBJECTIVE: The purpose of this case report was to describe a patient presenting with back pain subsequently diagnosed with thoracic schwannoma. CLINICAL FEATURES: A 45-year-old male presented to a chiropractic practice with mid-back, low back, and sacroiliac pain. Orthopedic examination revealed joint dysfunction in the thoracic-sacroiliac region with normal findings on neurologic examination. An initial diagnosis of thoracic spinal pain and sacroiliac sprain and strain was made. At approximately 7 weeks of treatment, because of the patient's persistent pain, chest magnetic resonance imaging (MRI) was ordered by the chiropractic physician. INTERVENTIONS AND OUTCOMES: The chest MRI revealed an intradural extramedullary mass at the T5 level creating a marked compression of the spinal cord. A thoracic MRI was conducted 2 days later confirming the presence of the tumor. The patient was successfully treated with spinal surgery to remove a schwannoma.
CONCLUSIONS: Mechanical spinal pain is a common symptom in patients presenting to chiropractic offices and may present concurrent with other pathology. In the presence of unresolved persistent thoracic pain, clinicians should investigate other potential causes.