Top

Published in:

Open Access 01-12-2024 | Case report

Concurrent spinal schwannoma and meningioma without neurofibromatosis: case presentation and review of literature

Authors: Hossam Elnoamany, Mohammud Salim

Published in: Egyptian Journal of Neurosurgery | Issue 1/2024

Abstract

Background

Concurrent multiple tumors developing in the spinal cord are rare, except for in genetic disorders, such as neurofibromatosis and von Hippel–Lindau disease. The presence of multiple histologically different spinal tumors in the absence of NF-2 is extremely rare. Schwannoma and meningioma can be explained partly by their common origin from the same mesenchymal cell, there is currently no explanation for the simultaneous existence of different spinal tumors other than simple coincidence.

Case presentation

After review of literature, there are thirteen such cases reported in the literature in addition to the present case. The current patient presents with lower limb weakness, and the patient radiology revealed intradural mass opposite the fourth lumbar vertebra with contrast enhancement and intradural extramedullary mass opposite the tenth dorsal vertebra with contrast enhancement in MRI spine. The coexistence of these tumors may be coincidental or might be due to a common histological origin of the Schwann cells and the meningocytes.

Conclusion

Schwannoma and meningioma have different radiological characteristics and require different managing procedures such as dural base coagulation in meningiomas and rootlet sacrifice in schwannomas.

Abul-Kasim K, Thurnher MM, McKeever P, Sundgren PC. Intradural spinal tumors: current classification and MRI features. Neuroradiology. 2008;50(4):301–14.CrossRefPubMed

Angiari P, Corradini L, Falasca A, Crisi G, Botticelli A, Merli G. Associated spinal meningioma and neurinoma. A case report. Acta Neurol. 1987;9(3):218–23.

Dorizzi A, Crivelli G, Marra A, Scamoni C, Dario A, Bonfanti N, et al. Associated cervical schwannoma and dorsal meningioma. Case report and review of the literature. J Neurosurg Sci. 1992;36(3):173–6.PubMed

Nishiura I, Koyama T, Tanaka K, Aii H, Amano S. The occurrence of different types of spinal tumours in one patient. Neurochirurgia. 1989;32(02):52–5.PubMed

Rajeswarie RT, Mallik D, Rudrappa S, Gopal S. Cases of mixed schwannoma–meningioma with and without neurofibromatosis 2 with emphasis on tumorigenesis. Int J Surg Pathol. 2023:10668969231188897.

Araszkiewicz H, Forgacz J, Markiewicz L, Mozański M. Neurofibroma and meningioma of the spinal canal. Neurol Neurochir Pol. 1988;22(3):264–7.PubMed

Ogihara S, Seichi A, Iwasaki M, Kawaguchi H, Kitagawa T, Tajiri Y, et al. Concurrent spinal schwannomas and meningiomas: case illustration. J Neurosurg Spine. 2003;98(3):300.CrossRef

Nakamizo A, Suzuki SO, Shimogawa T, Amano T, Mizoguchi M, Yoshimoto K, et al. Concurrent spinal nerve root schwannoma and meningioma mimicking single-component schwannoma. Neuropathology. 2012;32(2):190–5.CrossRefPubMed

Pagni C, Canavero S, Cento A. Multiple spinal meningiomas: case report and review of the literature. Zentralbl Neurochir. 1990;51(4):225–8.PubMed

10.

Chen K-Y, Wu J-C, Lin S-C, Huang W-C, Cheng H. Coexistence of neurofibroma and meningioma at exactly the same level of the cervical spine. J Chin Med Assoc. 2014;77(11):594–7.CrossRefPubMed

11.

Oichi T, Chikuda H, Morikawa T, Mori H, Kitamura D, Higuchi J, et al. Concurrent spinal schwannoma and meningioma mimicking a single cervical dumbbell-shaped tumor: case report. J Neurosurg Spine. 2015;23(6):784–7.CrossRefPubMed

12.

Liebelt BD, Haider AS, Steele WJ, Krishna C, Blacklock JB. Spinal schwannoma and meningioma mimicking a single mass at the craniocervical junction subsequent to remote radiation therapy for acne vulgaris. World Neurosurg. 2016;93:484.e13-e16.CrossRefPubMed

13.

Matsuda S, Kajihara Y, Abiko M, Mitsuhara T, Takeda M, Karlowee V, et al. Concurrent schwannoma and meningioma arising in the same spinal level: a report of two cases. NMC Case Rep J. 2018;5(4):105.CrossRefPubMedPubMedCentral

14.

Zhan Z, Yan X, Nie W, Ding Y, Xu W, Huang H. Neurofibroma and meningioma within a single dumbbell-shaped tumor at the same cervical level without neurofibromatosis: a case report and literature review. World Neurosurg. 2019;130:1–6.CrossRefPubMed

15.

Suematsu Y, Tsuji O, Nagoshi N, Nori S, Suzuki S, Okada E, et al. Concurrent dorsal subpial schwannoma and ventral meningioma arising at the same upper cervical level: a case report. Spinal Cord Series Cases. 2020;6(1):1–6.CrossRef

16.

McCormick PC. Surgical management of dumbbell and paraspinal tumors of the thoracic and lumbar spine. Neurosurgery. 1996;38(1):67–75.CrossRefPubMed

17.

Gezen F, Kahraman S, Çanakci Z, Bedük A. Review of 36 cases of spinal cord meningioma. Spine. 2000;25(6):727–31.CrossRefPubMed

18.

Suzuki A, Nakamura H, Konishi S, Yamano Y. Dumbbell-shaped meningioma with cystic degeneration in the thoracic spine: a case report. Spine. 2002;27(7):E193–6.CrossRefPubMed

19.

Matsumoto S, Hasuo K, Uchino A, Mizushima A, Furukawa T, Matsuura Y, et al. MRI of intradural-extramedullary spinal neurinomas and meningiomas. Clin Imaging. 1993;17(1):46–52.CrossRefPubMed

20.

Porčnik A, Žele T, Prestor B. Concurrent intradural meningioma and schwannoma at the same lumbar level in a patient without neurofibromatosis: a case report. Br J Neurosurg. 2020;34(1):104–6.CrossRefPubMed

21.

Kasantikul V, Netsky MG. Combined neurilemmoma and angioma: tumor of ectomesenchyme and a source of bleeding. J Neurosurg. 1979;50(1):81–7.CrossRefPubMed

22.

Shen W-C, Lee S-K. MRI of concurrent spinal meningioma, ependymoma, and syringomyelia. J Comput Assist Tomogr. 1992;16(4):665–6.PubMed

23.

Hokari M, Hida K, Ishii N, Seki T, Iwasaki Y, Nakamura N. Associated meningioma and neurofibroma at the same cervical level without clinical signs of neurofibromatosis: case report. No Shinkei Geka Neurological Surgery. 2002;30(9):953–7.PubMed

24.

Zhang N, Chen J, Ferraro GB, Wu L, Datta M, Jain RK, et al. Anti-VEGF treatment improves neurological function in tumors of the nervous system. Exp Neurol. 2018;299:326–33.CrossRefPubMed

25.

Gao X, Zhao Y, Stemmer-Rachamimov AO, Liu H, Huang P, Chin S, et al. Anti-VEGF treatment improves neurological function and augments radiation response in NF2 schwannoma model. Proc Natl Acad Sci. 2015;112(47):14676–81.CrossRefPubMedPubMedCentral

26.

Liu WC, Choi G, Lee S-H, Han H, Lee JY, Jeon YH, et al. Radiological findings of spinal schwannomas and meningiomas: focus on discrimination of two disease entities. Eur Radiol. 2009;19(11):2707–15.CrossRefPubMed

27.

Wein S, Gaillard F. Intradural spinal tumours and their mimics: a review of radiographic features. Postgrad Med J. 2013;89(1054):457–69.CrossRefPubMed

28.

Yamaguchi S, Takeda M, Takahashi T, Yamahata H, Mitsuhara T, Niiro T, et al. Ginkgo leaf sign: a highly predictive imaging feature of spinal meningioma. J Neurosurg Spine. 2015;23(5):642–6.CrossRefPubMed

Title: Concurrent spinal schwannoma and meningioma without neurofibromatosis: case presentation and review of literature
Authors: Hossam Elnoamany
Mohammud Salim
Publication date: 01-12-2024
Publisher: Springer Berlin Heidelberg
Published in: Egyptian Journal of Neurosurgery / Issue 1/2024
Electronic ISSN: 2520-8225
DOI: https://doi.org/10.1186/s41984-024-00334-0

Letter to the Editor regarding medical students’ perception toward neurosurgery as a career: a cross-sectional study

Open Access
Letter to the Editor

Septum pellucidum pilocytic astrocytoma: case report and literature review

Open Access
Case report

Surgical management of cervical intramedullary cavernoma: case report and systematic review of the literature

Open Access
Intramedullary Cavernoma
Case report

Socioeconomic profile of families with spina bifida children in Turkey

Open Access
Spina Bifida
Research

Surgical outcome of isolated benign peripheral nerve sheath tumors without neurofibromatosis

Open Access
Schwannoma
Research

The weekend effect in geriatric traumatic brain injury in tertiary hospital: an observational study

Open Access
Central Nervous System Trauma
Research

Keynote series | Spotlight on menopause

Menopause
Video Series

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the broader systemic effects of menopause, so you can help patients in your clinics through the transition.

Launching: Thursday 12th December 2024

Prof. Martha Hickey

Dr. Claudia Barth

Dr. Samar El Khoudary

Developed by: Springer Medicine

Advances in Alzheimer's

Alzheimer's Disease
Independent Medical Education

Alzheimer's research and care is changing rapidly. Keep up with the latest developments from key international conferences, together with expert insights on how to integrate these advances into practice.

This content is intended for healthcare professionals outside of the UK.

Supported by:

Lilly

Developed by: Springer Healthcare IME

Learn more