Intraosseous Schwannoma of the Thoracic Spine: A Case Report

Case Report | Volume 7 | Issue 3 | JBST September – December 2021 | Page 2-4 | Ikuo Kudawara, Hiroyuki Aono. DOI: DOI:10.13107/jbst.2021.v07i03.53

Author: Ikuo Kudawara[1], Hiroyuki Aono[1]

[1] Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, 2-1-14, Hoenzaka, Chuo-ku, Osaka 540-0006, Japan.

Address of Correspondence
Dr. Ikuo Kudawara,
Department of Orthopaedic Surgery, National Hospital Organization Osaka National Hospital, Japan.
E-mail: kudawara.ikuo.rf@mail.hosp.go.jp


Abstract

Introduction: Primary schwannoma of the bone is extremely rare. Spinal schwannoma usually rises in the nerve root or the cauda equina and their branches that occasionally scallop on the adjacent bone. On radiology, their features often mimic those of bone tumors such as osteoblastoma, hemangioma, aneurysmal bone cyst, plasmacytoma, or bone metastasis. Therefore, the diagnosis of pure spinal schwannoma of the bone should be evaluated carefully when referring to radiological and histopathological findings.
Case Report: A 64-year-old female presented with back pain and lower leg dysesthesia. The tumor within the left lamina of the 12th thoracic spine showed an expansile and lytic lesion on computed tomography (CT) and intermediate signals on the T1-weighted image and high signals on the T2-weighted image on magnetic resonance imaging. In addition, an old compression fracture in the same vertebra was observed. ACT-guided biopsy specimen suggested schwannoma. The tumor was successfully excised, and afterward, remission of the symptoms was observed. A definitive diagnosis of intraosseous schwannoma was made. There has been no recurrence in the 6 years following surgery.
Conclusion: We have presented the radiological and histopathological findings as well as the clinical outcomes of an unusual case of intraosseous schwannoma of the posterior element of the 12th thoracic spine. Pre-operative CT-guided biopsy was useful in making a diagnosis and planning a surgical strategy.

Keywords: Schwannoma, Thoracic spine, Bone.


References:

1. Mirra JM. Neurilemoma (Schwannoma). In: Mirra JM, editor. Bone Tumors. Philadelphia, PA, London: Lea & Febiger; 1989. p. 834-43.
2. Czerniak B. Intraosseous schwannoma. In: Czerniak B, editor. Dorfman and Czerniak’s Bone Tumors. 2nd ed. Philadelphia, PA: Elsevier; 2016. p. 1008-17.
3. Ida CM, Scheithauer BW, Yapicier Ö, Carney JA, Wenger DE, Inwards CY, et al. Primary schwannoma of the bone: A clinicopathologic and radiologic study of 17 cases. Am J Surg Pathol 2011;35:989-97.
4. BXu ZQ, Zhang P, Zhong ZH, Zhou W, Yu HT. Spinal intraosseous schwannoma without spinal canal and neuroforamina involvement: A case report. World J Clin Cases 2020;8:1271-7.
5. Nooraie H, Taghipour M, Arasteh MM, Daneshbod K, Erfanie MA. Intraosseous schwannoma of T12 with burst fracture of L1. Arch Orthop Trauma Surg 1997;116:440-2.
6. Ramasamy P, Shackleford I, Al Jaferari M. Schwannoma of T12 vertebra: Case report and review and review of literature. Sarcoma 2000;4:185-90.
7. Inaoka T, Takahashi K, Hanaoka H, Aburano T, Tokuhashi Y, Matsuno T, et al. Paravertebral neurinoma associated with aggressive intravertebral extension. Skeletal Radiol 2001;30:286-9.
8. Choudry Q, Younis F, Smith RB. Intraosseous schwannoma of D12 thoracic vertebra: Diagnosis and surgical management with 5-year follow-up. Eur Spine 2007;16 Suppl 3:283-6.
9. Cetinkal A, Atabey C, Kaya S, Colak A, Topuz AK. Intraosseous schwannoma of thoracic 12 vertebra without spinal canal involvement. Eur Spine J 2009;18 Suppl 2:236-9.
10. Kojima M, Seichi A, Yamamuro K, Inoue H, Kimura A, Hoshino Y. Intraosseous schwannoma originating from the posterior column of the thoracic spine. Eur Spine J 2011;20 Suppl 2:S153-6.
11. Kojima M, Seichi A, Yamamuro K, Inoue H, Kimura A, Hoshino Y. Intraosseous schwannoma originating from the posterior column of the thoracic spine. Eur Spine J 2011;20 Suppl 2:S153-6.
12. Jia S, Zheng W, Ruan J, Chen T, Huang Y, Guan J. Mobile thoracic schwannoma combined with intraosseous schwannomas. A case report. Medicine (Baltimore) 2019;98:e14153.
13. Rimondi E, Staals EL, Errani C, Bianchi G, Casadei R, Alberghini M, et al. Percutaneous CT-guided biopsy of the spine: Results of 430 biopsies. Eur Spine J 2008;17:975-81.


How to Cite this article: Kudawara I, Aono H | Intraosseous schwannoma of the thoracic spine: A case report. | Journal of Bone and Soft Tissue Tumors | Sep-Dec 2021; 7(3): 2-4.

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