Spinal schwannoma just below conus

Case contributed by A.Prof Frank Gaillard

Presentation

Lower limb symptoms.

Patient Data

Age: 34
Gender: Female

An ovoid intrathecal extramedullary mass is located at the level of the conus, but clearly not arising from it. It has a cystic centre and vivid peripheral enhancement. 

Case Discussion

It is difficult to be certain of the diagnosis on imaging criteria as both myxopapillary ependymomas and schwannomas can look just like this:

The very vivid enhancement and extremely well defined cystic component probably should make you favour a schwannoma. 

The patient went on to have a laminectomy and the mass was excised. 

Histology

MICROSCOPIC DESCRIPTION:

Paraffin sections show a partially cystic moderately hypercellular neurilemmoma (Schwannoma). This is composed of both Antoni-A and B type tissues. Moderately well formed Verocay bodies are seen in Antoni-A areas. No mitotic figures are identified. There are no densely hypercellular areas and no areas of necrosis are seen.

DIAGNOSIS: Partially cystic neurilemmoma (Schwannoma).

 

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Case information

rID: 32615
Case created: 5th Dec 2014
Last edited: 26th Apr 2017
System: Spine
Inclusion in quiz mode: Included

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