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Archives of Orthopaedic and Trauma Surgery

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01-04-2009 | Orthopaedic Surgery

Giant retroperitoneal schwannoma from the fifth lumbar nerve root with vertebral body osteolysis: a case report and literature review

Authors: En-Rung Chiang, Ming-Chau Chang, Tain-Hsiung Chen

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2009

Abstract

Study design

To report a rare case of retroperitoneal schwannoma from lumbar nerve root with difficult surgery and potential vascular complication.

Objective

We report a rare case of giant schwannoma which arises from fifth lumbar root with L5 vertebral body destruction.

Summary of background data

Retroperitoneal schwannomas are rare, and those with bony involvement are even rarer and may be mimicking malignant tumors.

Methods

Retroperitoneal removal of the tumor with partial killing of right L5 nerve root and allograft of L5 vertebral body defect were performed. Incidental injury of common iliac vein was encountered due to adhesion of the vein to tumor capsule. The laceration was repaired by cardiovascular surgeon.

Results

At final follow-up, the patient had mild weakness of dorsi-flexion of right ankle and mild right L5 dermatome numbness. No walking difficulty and no sign of local recurrence in the image studies.

Conclusions

Retroperitoneal schwannomas are rare, and they can become very large when diagnosed. Major vessels impingement and adhesion can occur which make the surgery difficult. Careful pre-operative evaluation and explanation is very important.

Albert FK, Oldenkott P, Bieker G et al (1988) Lumbar intervertebral disk herniation with a concomitant nerve root neurinoma at the same site. Case report and review of the literature. Neurochirurgia (Stuttg) 31:222–225

Atasoy E (1988) Thoracic outlet compression syndrome caused by a schwannoma of the C7 nerve root. J Hand Surg [Br] 22:662–663

Bocchini R, Broggi S, Gandini G et al (1987) A case of giant lumbar neurinoma. Minerva Med 78:1707–1710PubMed

Gross C, Lecocq J, Isner ME et al (2002) A rare cause of constipation: neurinoma of the fourth lumbar nerve. Case report and review of the literature. Ann Med Interne (Paris) 153:201–205

Gubbay AD, Moschilla G, Gray BN et al (1995) Retroperitoneal schwannoma: a case series and review. Aust N Z J Surg 65:197–200PubMedCrossRef

Harakuni T, Yoshii Y, Kinjyo T et al (2001) Schwannoma of the cervical spinal cord with cervical angina: a case report. No Shinkei Geka 29:641–645PubMed

Kalavakonda C, Sekhar LN, Jones RV et al (2000) Intermittent vertebral artery compression caused by C1-root schwannoma: case report. Neurol Res 22:679–684PubMed

Kato T, George B, Mourier KL et al (1993) Intraforaminal neurinoma in the lumbosacral region. Neurol Med Chir 33:86–91CrossRef

Khoshyomn S, Barth KN, Christman RA et al (2002) Torsion of a lumbar nerve root schwannoma. Pediatr Neurosurg 37:206–209PubMedCrossRef

10.

Kim JH, Lee JH, Park YK et al (2005) C-1 root schwannoma with aggressive lateral mass invasion. Yonsei Med J 46:575–578PubMedCrossRef

11.

Kim P, Ebersold MJ, Onofrio BM et al (1989) Surgery of spinal nerve schwannoma. Risk of neurological deficit after resection of involved root. J Neurosurg 71:810–814PubMed

12.

Kuo CH, Sheen IS, Wu CS (1990) Retroperitoneal neurilemoma: clinical features in 10 cases. J Formos Med Assoc 89:704–708PubMed

13.

Kyoshima K, Uehara T, Koyama J et al (2003) Dumbbell C2 schwannomas involving both sensory and motor rootlets: report of two cases. Neurosurgery 53:436–439PubMedCrossRef

14.

Lahat E, Rothman AS, Aron AM (1986) Schwannoma presenting as lumbar disc disease in an adolescent boy. Ann Neurol 20:643–644PubMedCrossRef

15.

Lesoin F, Rousseaux M, Martin HJ et al (1986) Astereognosis and amyotrophy of the hand with neurinoma of the second cervical nerve root. J Neurol 233:57–58PubMedCrossRef

16.

Mark S Cohen. (1999) Anatomy of the spinal nerve roots in the lumbar and lower thoracic spine. In: Harry N, Herkowitz, Steven R, Garfin, Richard A, Balderston et al (eds) The spine. 4th edn. W.B. Sanders, Philadelphia, pp 83–88

17.

Mayer HM, Wolff R, Mellerowicz H et al (1988) Neurinoma of the L3 spinal nerve root as a cause of stress-induced lumbo-ischialgias. Sportverletz Sportschaden 2:35–38PubMedCrossRef

18.

Miura T, Nakamura K, Tanaka H et al (1998) Resection of cervical spinal neurinoma including affected nerve root: recovery of neurological deficit in 15 cases. Acta Orthop Scand 69:280–282PubMedCrossRef

19.

Miyawaki T, Nakamura A, Hayashi H et al (1999) Macrocystic schwannoma in the seventh cervical nerve. Plast Reconstr Surg 104:789–792PubMedCrossRef

20.

Napolitano C, Mutter D, Steib IP et al (1998) A benign retroperitoneal schwannoma with vertebrallysis. A case report. Ann Ital Chir 69:815–816PubMed

21.

Otsuji E, Hagiwara A, Toma A et al (2003) Resection of a pelvic schwannoma with partial removal of the sacral nerve root. Hepatogastroenterology 50:99–101PubMed

22.

Paderni S, Boriani S (2002) Schwannoma of L3. Chir Organi Mov 87:133–139PubMed

23.

Sawada K, Nakagaki H, Kitamura K et al (1981) Three cases of cystic neurinoma arising from the upper cervical nerve roots and extending into the posterior cranial fossa (author’s transl). No Shinkei Geka 9:1425–1430PubMed

24.

Schultheiss R, Gullotta G (1993) Resection of relevant nerve roots in surgery of spinal neurinomas without persisting neurological deficit. Acta Neurochir (Wien) 122:91–96CrossRef

25.

Singh V, Kapoor R (2005) Atypical presentations of benign retroperitoneal schwannoma: report of three cases with review of literature. Int Urol Nephrol 37:547–549PubMedCrossRef

26.

Styczynski T, Zarski S (1988) A case of neurilemmoma of the L5 spinal nerve root with a clinical and radiculographic picture of intervertebral disk prolapse. Neurol Neurochir Pol 22:356–359PubMed

27.

Takanami I, Shikata J, Morota A et al (1991) Dumbbell type tumor of a nerve root treated surgically by vertical curvilinear approach. Nippon Kyobu Geka Gakkai Zasshi 39:430–434PubMed

28.

Takumi I, Isayama K, Osamura RY et al (2005) Intracisternal neurinoma of the C1 posterior root. Acta Neurochir (Wien) 147:1189–1192CrossRef

29.

Uchida K, Baba H, Maezawa Y et al (1996) Lumbosacral dumb-bell neurilemmoma approached by microsurgical interlaminar foraminotomy. A case report. Int Orthop 20:119–122PubMedCrossRef

30.

Ueda R, Yoshida K, Kawase T (2006) Intradural C-1 ventral root schwannomas treated by surgical resection via the lateral suboccipital transcondylar approach—three case reports. Neurol Med Chir (Tokyo) 46:298–301CrossRef

Title: Giant retroperitoneal schwannoma from the fifth lumbar nerve root with vertebral body osteolysis: a case report and literature review
Authors: En-Rung Chiang
Ming-Chau Chang
Tain-Hsiung Chen
Publication date: 01-04-2009
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2009
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-008-0635-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Giant retroperitoneal schwannoma from the fifth lumbar nerve root with vertebral body osteolysis: a case report and literature review

Abstract

Study design

Objective

Summary of background data

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Study design

Objective

Summary of background data

Methods

Results

Conclusions

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