Hemorrhagic Spinal Schwannoma

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Hemorrhagic Spinal Schwannoma
Thoracolumbar T2W1 MRI in the sagittal plane (a and b) and axial plane (c and d) at the tumor height. We can observe the growth of hyperintensity from T10 to L2 in (b) compared with the initial MRI taken (a). Tumor margins are marked with the arrows. Axial T2W1 images on the tumor edges are shown in (c) and (d); the tumor diameter and length have increased in the space of four months.

Hemorrhagic spinal schwannoma, a rare slow-growing nerve sheath tumour.

This article describes the case of a 38-year-old female patient who presented to the hospital with difficulty standing up from a squatting position with a history of 2 years. She also complained of heaviness and numbness in both her legs, radiating from the hips to the knees and ankles. Her history revealed that the symptoms had worsened in a time period of 4 months. In addition, both her lower limbs had become weaker. The patient was diagnosed with hemorrhagic spinal schwannoma.

Laboratory tests were unremarkable with no signs of infection. The tests were negative for tumour markers, also. Radiological examination was also unremarkable with no signs of abnormalities. Doctors advised an MRI which showed a tumour in the intradural region at the level of T10-T12. The patient was advised surgery for removal of the tumour. However, the patient refused surgery and preferred a bone setter. 2 months later the patient was back at the hospital with a complaint of profound weakness on her lower extremity.

The patient’s physical examination was significant for paresis on both lower extremities from her thigh in left and lower right limbs.

Her patellar reflexes were exaggerated in both limbs. Doctors advised another MRI which showed that the mass had grown to lumbar vertebrae L2. In addition, the patient also showed worsening of neurological statuses and impaired sensibility with urinary and defecation problems. The findings led to the diagnosis of Hemorrhagic schwannoma in the medulla spinalis, a rare slow-growing nerve sheath tumour. The patient underwent a spinal manipulation procedure.

She was further advised a surgical procedure for decompression and exploration. However, the patient did not gain function of her lower extremities at the time she was being discharged. There were some improvements in her lower extremity at 6 months follow-up. The patient was able to walk with help from a walker. Although, there were no improvements in her bowel movements and urination.

References

Hemorrhagic Spinal Schwannoma in Thoracolumbar Area with Total Paraplegia https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334320/

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.

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