Intradural Cervical Schwannoma - Case Presentation

Very pleasant 56-year old male with a long history of left scapular pain which is worse at night. The patient denied any weakness, numbness, tingling, bowel or bladder dysfunction, or difficulty with ambulation. His past medical history was significant for resection of multiple lipomas and resection of nerve sheath tumor from his left chest region. Physical examination showed full motor strength in all major muscle groups, intact sensation and no signs of myelopathy.

Sagittal MRI of Cervical Spine	MRI demonstrated a homogeneously enhancing mass in the left anterolateral region, extending from C7 to T1. The spinal cord was severely indented. There were no cord signal changes noted within the cord itself. This very large intradural extramedullary lesion was most likely consistent with Schwannoma.
	Axial MRI of Cervical Spine	1 - TUMOR 2 - SPINAL CORD 3 - CEREBROSPINAL FLUID 4 - C7 - CERVICAL VERTEBRAE     * click images to view larger

The patient underwent C6 to T1 laminectomies, intradural exploration with gross total resection of tumor using microdissection.

Intact dura	Opened dura with tumor	Tumor was removed	Closed dura

EMG and SSEP was monitored through entire procedure. The patient was discharged from hospital three days after his surgery. His follow-up physical examination showed full motor strength in all major muscle groups and mildly diminished sensation along the small and ring fingers of his left hand. Final pathology report confirmed diagnosis of Schwannoma. Follow-up MRI showed no residual tumor.