Spinal schwannoma

Case contributed by Dr Lawrence Chia Wei Oh

Presentation

CT urography for right flank pain

Patient Data

Age: 60 years old
Gender: Male
Modality: CT

CT urography demonstrates a 3mm calculus in the distal part of right ureter with proximal ureter dilatation.

Incidentally, it also demonstrates an expansile soft tissue mass at T12 / L1 level extending into the left intervertebral foramen. The lesion also causes marginal sclerosis and foraminal remodelling consistent with a chronic lesion.

The patient went on to have MRI of spine for further evaluation of the soft tissue mass.

Modality: MRI

This MRI spine demonstrates an expansile soft tissue mass (extradural) lesion at T12/L1 level expanding into the left intervertebral foramen. It is T2 hyperintense and T1 hypointense. It is also enhanced with contrast.

Case Discussion

The patient went on to have a left hemilaminectomy and excision of an extradural tumor. Intra-operatively, the lesion was noted to erode through anterior vertebral body with the T12 nerve root travelling through the lesion. It derived its blood supply from the intercostal artery.

Histology

MACROSCOPIC DESCRIPTION:
Left T12/L1 extradural content/tumour: Six pieces of firm white to haemorrhagic tissue

MICROSCOPIC DESCRIPTION:
Sections demonstrate a benign spindled lesion. The lesion shows broad areas of sclerosis and low cellularity as well as focal Verrocay bodies. Hyalinised vasculature is noted. An occasional enlarged and hyperchromatic cell nucleus is present, however no necrosis is seen and the mitotic rate is not elevated. A nerve ganglion is seen at the lesion edge.

DIAGNOSIS: Schwannoma.

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Case Information

rID: 24163
Case created: 30th Jul 2013
Last edited: 27th Feb 2016
Inclusion in quiz mode: Included

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