Spinal schwannoma just below conus
Lower limb symptoms.
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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.
1 case question available
It is difficult to be certain of the diagnosis on imaging criteria as both myxopapillary ependymomas and schwannomas can look just like this:
- this other case is an example of a myxopapillary ependymoma
- this other case is an example of a spinal schwannoma
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.
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).