====== Thoracic spinal schwannoma ====== {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1FeQVcsSJohxHRcIQ0CTQGMPHb08lqbZlixYbOa3jKb3BFykqm/?limit=15&utm_campaign=pubmed-2&fc=20230103065105}} ---- ---- Specifically, a thoracic [[spinal schwannoma]] is a [[schwannoma]] that develops in the [[thoracic region]] of the [[spine]]. Schwannomas in the thoracic spine are relatively uncommon compared to those in other regions of the spine. They typically arise from the [[spinal nerve root]]s or the nerves within the [[spinal canal]]. ===== Epidemiology ===== see [[Spinal schwannoma epidemiology]]. ---- Prevalence: Thoracic spinal schwannomas are considered relatively rare compared to schwannomas in other regions of the spine. ---- ===== Thoracic spinal schwannoma classification ===== {{rss>https://pubmed.ncbi.nlm.nih.gov/rss/search/1ZK2-GOkRV8FseGW-DzlmecsEkRow0C1WXOyE-10R0ei4TcQS8/?limit=15&utm_campaign=pubmed-2&fc=20230706040254}} see [[Spinal schwannoma classification]] Dumbbell-shaped thoracic [[spinal tumor]]s represent a distinct type of tumor and involve in both the spinal canal and the posterior thoracic cavity. Successful treatment for the tumors depends on [[gross total resection]] (GTR) via an open [[laminectomy]] and facetectomy or [[transthoracic transpleural approach]]. ===== Clinical features ===== It is important to note that the clinical presentation of thoracic spinal schwannomas can vary, and some individuals may remain asymptomatic for an extended period, especially if the tumor is small or slow-growing. see [[Spinal tumor clinical features]]. ===== Diagnosis ===== [[Spinal schwannoma diagnosis]]. ===== Treatment ===== [[Spinal schwannoma treatment]] ===== Case series ===== Patients who underwent surgery for spinal intradural pathology from January 2008 to December 2019 were retrospectively reviewed. Those who received [[laminoplasty]] using the Leibinger mini-plate and were followed for more than 2 years were included. Patient demographics and clinical and radiographic data were reviewed and analyzed. A total of 117 patients (male:female = 47:70; mean age 50.9 years, range 16-92 years) were included, and mean follow-up period was 50.3 months (range 24-151 months). The most common pathology was [[schwannoma]] (n = 66, 56.4%) followed by [[meningioma]] (n = 30, 25.6%). [[Gross total resection]] was achieved in 82.9% (n = 97). Clinical outcomes at last follow-up were mostly good and excellent (n = 95, 81.2%). [[Computed tomography]] at the postoperative 1-year follow-up were available in 32 patients (27.4%) and the overall fusion rate was 89.3% (50 of 56 laminae). The fusion rate was significantly lower in the [[cervical spine]] compared to other locations (50% vs. thoracic [100%], lumbar [85.7%], P < 0.002). No displacement of laminae or postoperative [[spinal deformity]] were observed throughout the follow-up. Laminoplasty using L-shape Leibinger mini-plates had an 89.3% fusion rate, and no displacement of the re-attached laminae was observed. Lee et al. think it is a safe and feasible option in surgeries for intraspinal pathologies ((Lee S, Min S, Han J, Kim ES, Lee SH. Long-term Follow-up Results of Reconstructive Laminoplasty With L-shaped Leibinger Mini-plate for Posterior Approach in the Treatment of Intraspinal Tumor Surgery. World Neurosurg. 2022 Dec 12:S1878-8750(22)01733-8. doi: 10.1016/j.wneu.2022.12.029. Epub ahead of print. PMID: 36521755.)). ===== Case reports ===== [[Thoracic spinal schwannoma case reports]]. ===== Case reports from the HGUA ===== ==== I14321 ==== [[Intradural extramedullary spinal tumor]]. Suspicion of [[Thoracic spinal schwannoma]] at the level of vertebra T11 and T12. {{:pasted:20240214-075410.png}} The largest lesion measuring 16 mm, compressing and displacing the spinal cord to the left. Multilevel lumbar [[spondyloarthrosis]] with severe [[canal stenosis]] at L4/L5. Modic II changes in vertebral endplates at L5/S1 and degenerative spondylolisthesis grade I-II at L4/L5. Ascending paresthesias to the knee, lumbar pain radiating to the lower limbs, vesical sphincter dysfunction, and constipation. Examination results: Phosphorus: 3.58 mg/dL Sodium: 140 mmol/L Potassium: 4.58 mmol/L AST: 22 U/L ALT: 20 U/L Gamma GT: 24.0 U/L Immunoglobulin G: 971 mg/dL Ferritin: 355 ng/mL CEA, CA-19.9, CA-15.3, CA-125, AFP within normal levels. MRI of the lumbar spine revealed intradural extramedullary nodular lesions. Discharge treatment: Routine treatment. Medications such as omeprazole, enoxaparin, dexamethasone, naproxen, tramadol, acetylcysteine, and diclofenac. Recommendations: Notify by phone with pending surgery date. Circumstances at discharge: Residence. Main diagnosis: Intradural extramedullary Schwannoma. Influenza A. Other diagnoses: Multilevel lumbar spondyloarthrosis with canal stenosis. Degenerative changes in the lumbar spine. Progress: Good respiratory progress. Pending surgery. Isolation lifted for influenza A.