Giant lumbar Schwannoma

Case contributed by Dr Chris O'Donnell

Presentation

Painless progessive right foot drop with CT scan apparently showing no disc prolapse.

Patient Data

Age: 35 years old
Gender: Male
Modality: MRI

Large, enhancing extra-axial mass in the upper lumbar spinal canal deviating the conus to the left and expanding the spinal canal by way of posterior vertebral body "scalloping".  The post-op scan shows an extensive laminaectomy and pseudo-meningocoele.

Histology revealed a schwannoma.

Case Discussion

What is remarkable in this case is the relatively minor clinical signs associated with this huge mass. ie. foot drop and no pain.  This is presumably due to the slow growth of the tumour causing pressure erosion on the spinal canal.  The contemporary preliminary CT (not available to me in this case) apparently did not show an obvious mass in the spinal canal. 

Look at the T1 sagittal images and perhaps you could make the same mistake.

PlayAdd to Share

Case Information

rID: 50048
Diagnostic certainty: Certain
Case created: 16th Dec 2016
Last edited: 3rd Jan 2017
System: Spine
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.