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Giant schwannoma of thoracic vertebra: A case report

Zhou, Y; Liu, CZ; Zhang, SY; Wang, HY; Varma, SN; Cao, LQ; Hou, TT; ... Yao, BJ; + view all (2021) Giant schwannoma of thoracic vertebra: A case report. World Journal of Clinical Cases , 9 (36) pp. 11448-11456. 10.12998/wjcc.v9.i36.11448. Green open access

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Abstract

BACKGROUND,It is relatively rare for schwannomas to invade bone, but it is very rare for a large,mass to form concurrently in the paravertebral region. Surgical resection is the,only effective treatment. Because of the extensive tumor involvement and the,many important surrounding structures, the tumor needs to be fully exposed.,Most of the tumors are completely removed by posterior combined open-heart,surgery to relieve spinal cord compression, restore the stability of the spine and,maximize the recovery of nerve and spinal cord function. The main objective of,this article is to present a schwannoma that had invaded the T5 and T6 vertebral,bodies and formed a large paravertebral mass with simultaneous invasion of the,spinal canal and compression of the spinal cord.,CASE SUMMARY,A 40-year-old female suffered from intermittent chest and back pain for 8 years.,Computed tomography and magnetic resonance imaging scans showed a,paravertebral tumor of approximately 86 mm × 109 mm × 116 mm, where the,adjacent T5 and T6 vertebral bodies were invaded by the tumor, the right intervertebral,foramen was enlarged, and the tumor had invaded the spinal canal to,compress the thoracic medulla. The preoperative puncture biopsy diagnosed a,benign schwannoma. Complete resection of the tumor was achieved by a two-step,operation. In the first step, the thoracic surgeon adopted a lateral approach to,separate the thoracic tumor from the lung. In the second step, a spine surgeon,performed a posterior midline approach to dissect the tumor from the vertebral,junction through removal of the tumor from the posterior side and further,resection of the entire T5 and T6 vertebral bodies. The large bone defect was,reconstructed with titanium mesh, and the posterior root arch was nail-fixed. Due,to the large amount of intraoperative bleeding, we performed tumor angioembolization,before surgery to reduce and avoid large intraoperative bleeding. The,postoperative diagnosis of benign schwannoma was confirmed by histochemical,examination. There was no sign of tumor recurrence or spinal instability during,the 2-year follow-up.,CONCLUSION,Giant schwannoma is uncommon. In this case, a complete surgical resection of a,giant thoracic nerve sheath tumor that invaded part of the vertebral body and,compressed the spinal cord was safe and effective.

Type: Article
Title: Giant schwannoma of thoracic vertebra: A case report
Open access status: An open access version is available from UCL Discovery
DOI: 10.12998/wjcc.v9.i36.11448
Publisher version: http://dx.doi.org/10.12998/wjcc.v9.i36.11448
Language: English
Additional information: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: htt p://creativecommons.org/License s/by-nc/4.0/
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Ortho and MSK Science
URI: https://discovery.ucl.ac.uk/id/eprint/10142216
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