Thoracic intramedullary schwannoma [Neurosurgery Wiki]

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====== Thoracic intramedullary schwannoma ======

===== Case series =====

5 patients with pathologically confirmed [[intramedullary schwannoma]]s were reviewed.
The majority were [[hypointense]] on [[T1]]-weighted images and hypo-[[hyperintense]] on [[T2]]-weighted images. [[Peritumoral edema]] was easily found. [[Gadolinium]] enhancement was obviously. No [[recurrence]] was seen during the follow-up period
((Gao L, Sun B, Han F, Jin Y, Zhang J. Magnetic Resonance Imaging Features of
Intramedullary Schwannomas. J Comput Assist Tomogr. 2017 Jan;41(1):137-140. doi: 
10.1097/RCT.0000000000000493. PubMed PMID: 27680415.)).

===== Case reports =====

Dhake and Chatterjee from the Department of Neurosurgery, Park clinic, [[Kolkata]], India, described two cases of thoracic intramedullary schwannomas that recurred after primary excision. A 10 years old boy presented with [[weakness]] of both lower limbs. [[Magnetic resonance imaging]] showed a D10 to D12 [[intramedullary]] lesion, which was excised near totally and confirmed to be a [[schwannoma]] on histopathological examination. The tumour recurred twice after that and was re operated both times. Another 57 years old lady presented with weakness of both lower limbs and a history of being operated in the past for D9-D10 intramedullary lesion. She was re-operated with total [[removal]] of the lesion confirmed to be schwannoma on histopathological examination. Intramedullary schwannoma may recur after resection.
((Dhake RP, Chatterjee S. Recurrent thoracic intramedullary schwannoma: report
of two cases with long term follow up. Br J Neurosurg. 2019 Mar 5:1-4. doi:
10.1080/02688697.2019.1566516. [Epub ahead of print] PubMed PMID: 30836024.
)).
----
A rare case of thoracic intramedullary tumour in a 28 year old male patient who presented with progressive weakness of both the lower limbs and decreased sensation below D2 dermatomal level. Magnetic resonance imaging revealed an intramedullary lesion from D1 toD7. D1 to D7 laminoplasty and near total excision of the mass done. Total removal was difficult because of the infiltrative nature of the tumour
((Nayak R, Chaudhuri A, Chattopadhyay A, Ghosh SN. Thoracic intramedullary
schwannoma: A case report and review of literature. Asian J Neurosurg. 2015
Apr-Jun;10(2):126-8. doi: 10.4103/1793-5482.145155. PubMed PMID: 25972946; PubMed
Central PMCID: PMC4421952.
)). 
----
A 68-year-old male presented with walking disturbance and decreased sensation below T10 dermatome. Imaging workup revealed an intramedullary mass at T6 and T7. T6 and T7 laminectomy and mass removal were performed. Intraoperatively, extramedullary beads-like daughter masses along the nerve roots adjacent to intramedullary mass were identified. Total removal of intramedullary lesion and partial resection of extramedullary masses were done. Histological analysis confirmed the diagnosis of schwannoma. The patient could ambulate independently at postoperative 1 month without any neurological sequelae. The authors experienced a surgical case of intramedullary schwannoma accompanying by extramedullary beads-like same pathologies in the thoracic spine
((Ryu KS, Lee KY, Lee HJ, Park CK. Thoracic intramedullary schwannoma
accompanying by extramedullary beads-like daughter schwanommas. J Korean
Neurosurg Soc. 2011 May;49(5):302-4. doi: 10.3340/jkns.2011.49.5.302. Epub 2011
May 31. PubMed PMID: 21716630; PubMed Central PMCID: PMC3115155.
)).

===== References =====