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Medicine (Baltimore). 2018 Sep;97(39):e12474. doi: 10.1097/MD.0000000000012474.

Lumbar intraspinal microcystic/reticular schwannoma: Case report and literature review.

Liu C1, Yan L1,2,3, Liu Q4, Li J4, Jin H5, Wang J1,2,3, Deng Y6,4.

Author information

1
Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan.
2
Department of Orthopedics, Clinical medical college of Yangzhou University.
3
Orthopedics Institute, Subei People's Hospital of Jiangsu Province, Yangzhou, Jiangsu.
4
Department of Spine Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan.
5
Department of Pathology, Shen Zhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen, Guangdong.
6
Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.

Abstract

RATIONALE:

Microcystic/reticular schwannoma (MRS) is a rare histological variant of schwannoma which was initially described in 2008 with a predilection for the visceral organs. This distinct tumor had been reported to mainly affect gastrointestinal tract, subcutaneous and soft tissue, various glands and head and neck region. However, MRS involving spine is extremely rare.

PATIENT CONCERNS:

The authors report the first case of MRS occurring in the lumbar (L) spinal canal of a 40-year-old male who presented with continuous pain and numbness in both feet for 2.5 years. Physical examination revealed weakness of lower extremities and hyperalgesia of both feet.

DIAGNOSES AND INTERVENTIONS:

The findings of pre-operative investigation were suspicious for either a schwannoma or a spinal meningioma. Accordingly, total laminectomy, complete tumor resection, instrumentation and spinal fusion were performed. Post-operative histopathologic examination revealed a well-encapsulated neoplasm with reticular and microcystic growth pattern. Antoni A and Antoni B regions, Verocay bodies and hyalinized blood vessels were observed. And cytologic atypia, necrosis or mitosis was absent. Immunohistochemically, the tumor cells showed strong and diffuse positivity for S-100 as well as SOX 10. Therefore, a histopathological diagnosis of MRS was finally made.

OUTCOMES:

The patient remains well with no evidence of recurrence at a 22-month follow-up.

LESSONS:

This is the first case of MRS which is located in the L spinal canal. Awareness of this distinctive entity is helpful in preventing diagnostic pitfalls and making correct treatment strategies.

PMID:
30278533
PMCID:
PMC6181603
DOI:
10.1097/MD.0000000000012474
[Indexed for MEDLINE]
Free PMC Article

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