A M Samman1, A M Bardeesi2, M T Alzahrani3,4. 1. Section of Neurosurgery, Department of Surgery, King Abdulaziz Medical city National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia. afnan.m.samman@gmail.com. 2. Section of Neurosurgery, Department of Neurosciences, King Faisal Specialist Hospital and Research Center (Gen. Org) - Jeddah Branch, Jeddah, Saudi Arabia. 3. Section of Neurosurgery, Department of Surgery, King Abdulaziz Medical city National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia. 4. Neurosurgery College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
Abstract
INTRODUCTION: Schwannomas are the second most common type of intra-dural lesions involving the thoracic spine. They are frequently seen as solid and heterogeneous lesions. Totally cystic thoracic schwannomas represent a rare pathological schwannoma variant, with only four cases reported in the English literature to our knowledge. CASE PRESENTATION: We report an 80-year-old male who presented with upper back pain for 3 months. Magnetic resonance imaging (MRI) showed a cystic lesion at the level of T6-T7 with peripheral contrast enhancement. The lesion was removed in total surgically with complete resolution of the patient's symptoms. DISCUSSION: The diagnosis of cystic schwannomas is often delayed due to the paucity of symptoms and the lack of meticulous investigation. The presence of rim enhancement on contrast-enhanced MRI may be the only clue for the diagnosis. It is important to consider cystic schwannomas in the differential diagnosis of cystic spinal lesions since the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.
INTRODUCTION: Schwannomas are the second most common type of intra-dural lesions involving the thoracic spine. They are frequently seen as solid and heterogeneous lesions. Totally cystic thoracic schwannomas represent a rare pathological schwannoma variant, with only four cases reported in the English literature to our knowledge. CASE PRESENTATION: We report an 80-year-old male who presented with upper back pain for 3 months. Magnetic resonance imaging (MRI) showed a cystic lesion at the level of T6-T7 with peripheral contrast enhancement. The lesion was removed in total surgically with complete resolution of the patient's symptoms. DISCUSSION: The diagnosis of cystic schwannomas is often delayed due to the paucity of symptoms and the lack of meticulous investigation. The presence of rim enhancement on contrast-enhanced MRI may be the only clue for the diagnosis. It is important to consider cystic schwannomas in the differential diagnosis of cystic spinal lesions since the best surgical outcome is strongly related to earlier diagnosis and total resection of the lesion.
Authors: K Santhosh; C Kesavadas; B Thomas; A K Gupta; T R Kapilamoorthy; V V Radhakrishnan Journal: Singapore Med J Date: 2009-01 Impact factor: 1.858