Case Report
BibTex RIS Cite

Year 2020, , 122 - 125, 20.05.2020

İsmail Kaya

https://doi.org/10.7197/cmj.vi.736344

Abstract

Paraspinal schwannomlar göreceli olarak yaygın olmakla birlikte spinal cerrahide yeterli sınıflandırılamamış bir konudur. Diskojenik olmayan bel ağrısına neden olan nadir ve sınıflandırılmamış paravertebral schwannom olgusunu sunuyoruz.
45 yaşında kadın hasta bel ağrısı ile kliniğimize geldi. Şikayeti iki yıl içinde mütemadiyen kötüleşti. Fizik muayenesinde, sağ bacakta 45 derecelik açıda laseque testinde pozitiflik vardı, ancak provokasyon testi negatif olduğu görüldü. Manyetik rezonans görüntülemede paravertebral kasta sağ lomber 3-4 faset eklem kaynaklı bir kitle saptandı.
Planlanan cerrahiye göre hasta ameliyat edildi. Histopatolojik tanı schwannom olarak doğrulandı. Hasta 2 sene boyunca ağrı ve nörolojik defisit olmadan takip etti. Takip manetik rezonans görüntülemesinde kitle kalıntısı veya nüksü izlenmedi.
Açıklanamayan diskojenik olmayan bel ağrısının ayırıcı tanısı için Schwannomlar dikkate alınmalıdır. Yaygın hasta gruplarına göre yeni sınıflandırma sistemleri sunulmalıdır.

References

  • 1. Khoshyomn, S., et al., Torsion of a lumbar nerve root schwannoma. Pediatr Neurosurg. 37(4): p. 206-9, 2002.
  • 2. Beaman, F.D., M.J. Kransdorf, and D.M. Menke, Schwannoma: radiologic-pathologic correlation. Radiographics. 24(5): p. 1477-81, 2004.
  • 3. Lahat, E., A.S. Rothman, and A.M. Aron, Schwannoma presenting as lumbar disc disease in an adolescent boy. Ann Neurol. 20(5): p. 643-4, 1986.
  • 4. Lu, D.C., S.S. Dhall, and P.V. Mummaneni, Mini-open removal of extradural foraminal tumors of the lumbar spine. J Neurosurg Spine. 10(1): p. 46-50, 2009.
  • 5. Russell, S.M., Preserve the nerve: microsurgical resection of peripheral nerve sheath tumors. Neurosurgery. 61(3 Suppl): p. 113-7; discussion 117-8, 2007.
  • 6. Rustagi, T., S. Badve, and A.N. Parekh, Sciatica from a foraminal lumbar root schwannoma: case report and review of literature. Case Rep Orthop. 2012: p. 142143, 2012.
  • 7. Park, S.C., et al., Spinal intraosseous schwannoma : a case report and review. J Korean Neurosurg Soc. 46(4): p. 403-8, 2009.
  • 8. Sridhar, K., et al., Giant invasive spinal schwannomas: definition and surgical management. J Neurosurg. 94(2 Suppl): p. 210-5, 2001.

An unusual case of paraspinal schwannoma causing undiagnosed low back pain

Year 2020, , 122 - 125, 20.05.2020

İsmail Kaya

https://doi.org/10.7197/cmj.vi.736344

Abstract

Paraspinal schwannomas are relatively common but hardly classified subject of spinal neurosurgery. We present a rare and unclassified case of paravertebral schwannoma that causes non-discogenic low back pain. A 45-year-old Caucasian female came to our clinic with low back pain. Her pain steadily worsened for two years. Her physical exam showed right straight leg raise positivity at 45-degree angle but provocation test negative. Magnetic resonance imaging showed a mass in the paravertebral muscle originating right lumbar 3-4 facet joint. According to planned surgery patient operated. Histopathological diagnosis confirmed as schwannoma. The patient followed for 2 years without pain and neurologic deficiency. Follow up magnetic resonance imaging showed no residue or recurrence of the mass. Schwannomas must be taken into account for differential diagnosis of unexplained non-discogenic low back pain. New classification systems must be offered based on widespread patient groups. 

Keywords

Paraspinal schwannomas non-discogenic low back pain paraspinal schwannoma classification Surgical removal

References

  • 1. Khoshyomn, S., et al., Torsion of a lumbar nerve root schwannoma. Pediatr Neurosurg. 37(4): p. 206-9, 2002.
  • 2. Beaman, F.D., M.J. Kransdorf, and D.M. Menke, Schwannoma: radiologic-pathologic correlation. Radiographics. 24(5): p. 1477-81, 2004.
  • 3. Lahat, E., A.S. Rothman, and A.M. Aron, Schwannoma presenting as lumbar disc disease in an adolescent boy. Ann Neurol. 20(5): p. 643-4, 1986.
  • 4. Lu, D.C., S.S. Dhall, and P.V. Mummaneni, Mini-open removal of extradural foraminal tumors of the lumbar spine. J Neurosurg Spine. 10(1): p. 46-50, 2009.
  • 5. Russell, S.M., Preserve the nerve: microsurgical resection of peripheral nerve sheath tumors. Neurosurgery. 61(3 Suppl): p. 113-7; discussion 117-8, 2007.
  • 6. Rustagi, T., S. Badve, and A.N. Parekh, Sciatica from a foraminal lumbar root schwannoma: case report and review of literature. Case Rep Orthop. 2012: p. 142143, 2012.
  • 7. Park, S.C., et al., Spinal intraosseous schwannoma : a case report and review. J Korean Neurosurg Soc. 46(4): p. 403-8, 2009.
  • 8. Sridhar, K., et al., Giant invasive spinal schwannomas: definition and surgical management. J Neurosurg. 94(2 Suppl): p. 210-5, 2001.
There are 8 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Reports
Authors

İsmail Kaya 0000-0002-4128-5845

Publication Date May 20, 2020
Acceptance Date May 20, 2020
Published in Issue Year 2020

Cite

AMA Kaya İ. An unusual case of paraspinal schwannoma causing undiagnosed low back pain. CMJ. May 2020;42(1):122-125. doi:10.7197/cmj.vi.736344