Spinal schwannoma just below conus

Case contributed by Frank Gaillard
Diagnosis certain


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 center 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 favor 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).


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