Giant schwannoma with extensive scalloping of the lumbar vertebral body treated with one-stage posterior surgery: a case report

We report a case of cellular schwannoma, a rare benign nerve-sheath tumor in a 27 year-old woman. It was presented as a voluminous lesion in the paraspinal region that caused lumbar vertebral body destruction. These features, in association to the microscopic aspects of a hypercellular, pleomorphic neoplasm may lead to a false impression of a malignant tumor. Therefore, it is important to have an accurate examination to confirm the benign nature of this tumor thus avoiding unnecessary therapy.

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Progressive destruction of the 1st lumbar vertebral body caused by rheumatoid involvement: A case report.

Orthopedics & Traumatology ◽

10.5035/nishiseisai.36.457 ◽

1987 ◽

Vol 36 (2) ◽

pp. 457-461

Author(s):

Shingo Naniwa ◽

Motiru Kamihira ◽

Kenji Ohtsuki ◽

Yasuo Morio ◽

Kanichi Hayashi

Keyword(s):

Case Report ◽

Vertebral Body ◽

Lumbar Vertebral Body

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Monostotic fibrous dysplasia of a lumbar vertebral body with secondary aneurysmal bone cyst formation: a case report

Journal of Medical Case Reports ◽

10.4076/1752-1947-3-7227 ◽

2009 ◽

Vol 3 (1) ◽

pp. 7227 ◽

Cited By ~ 6

Author(s):

Marieke N Snieders ◽

Folkert J van Kemenade ◽

Barend J van Royen

Keyword(s):

Case Report ◽

Fibrous Dysplasia ◽

Vertebral Body ◽

Aneurysmal Bone Cyst ◽

Bone Cyst ◽

Cyst Formation ◽

Lumbar Vertebral Body ◽

Secondary Aneurysmal Bone Cyst

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Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

Open Medicine ◽

10.2478/s11536-008-0006-1 ◽

2008 ◽

Vol 3 (2) ◽

pp. 233-244 ◽

Cited By ~ 3

Author(s):

Marija Sakalauskaite ◽

Juozas Stanaitis ◽

Saulius Cepkus ◽

Mindaugas Pleckaitis ◽

Raimundas Lunevicius

Keyword(s):

Case Report ◽

Vertebral Body ◽

Surgical Excision ◽

Negative Influence ◽

Retroperitoneal Space ◽

Benign Schwannoma ◽

Complete Surgical Excision ◽

Giant Schwannoma ◽

Retroperitoneal Schwannoma ◽

The Right

AbstractA huge schwannoma, located in the retroperitoneal space, is found very rarely. The main purpose of this paper is to present the case of a giant retroperitoneal schwannoma which partly invaded L4 vertebral body. The secondary purpose is to summarize the case-report articles on retroperitoneal schwannomas. A circumscribed heterogenic tumour was revealed on transabdominal sonography. It extended into the right retroperitoneal space. CT and MRI revealed a paravertebral tumour in the size of 11 cm × 9 cm, which is causing a partial lysis of L4 vertebral body (15% of vertebral capacity), expanding intravertebral foramen and filling the right retroperitoneal space. A preoperative core needle biopsy was performed and a benign schwannoma was diagnosed. A complete surgical excision of the tumour was achieved by a two-step operation. During the first step, the neurosurgeons made L4 hemilaminectomy, facetectomy and a transverse process resection by posterior extended approach. The general surgeons excised the residual retroperitoneal part of the tumour by midline transabdominal approach 10 days later. The diagnosis of benign schwannoma was verified histochemically. There were no sign of tumour recurrence or spine destabilization at the six-month follow-up. In conclusion, although majority of giant retroperitoneal schwannomas can be completely removed performing one-step operation, a preoperative consideration about rationality of two-step operation should be mandatory when tumour destructs a part of vertebral body. Our case shows that the combined two stage complete surgical excision of a giant retroperitoneal schwannoma, eroding 15% of L4 vertebra’s osseous capacity, is effective and does not have any negative influence on spinal stability.

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Effect of CT-based attenuation correction on uptake ratios in skeletal SPECT

Nuklearmedizin ◽

10.1055/s-0037-1616624 ◽

2007 ◽

Vol 46 (01) ◽

pp. 38-42 ◽

Cited By ~ 12

Author(s):

V. Schulz ◽

I. Nickel ◽

A. Nömayr ◽

A. H. Vija ◽

C. Hocke ◽

...

Keyword(s):

Vertebral Body ◽

Facet Joint ◽

One Dimension ◽

Patient Specific ◽

Data Sets ◽

Facet Joints ◽

Lumbar Vertebral Body ◽

Ct System ◽

Ct Data ◽

Attenuation Corrected

SummaryThe aim of this study was to determine the clinical relevance of compensating SPECT data for patient specific attenuation by the use of CT data simultaneously acquired with SPECT/CT when analyzing the skeletal uptake of polyphosphonates (DPD). Furthermore, the influence of misregistration between SPECT and CT data on uptake ratios was investigated. Methods: Thirty-six data sets from bone SPECTs performed on a hybrid SPECT/CT system were retrospectively analyzed. Using regions of interest (ROIs), raw counts were determined in the fifth lumbar vertebral body, its facet joints, both anterior iliacal spinae, and of the whole transversal slice. ROI measurements were performed in uncorrected (NAC) and attenuation-corrected (AC) images. Furthermore, the ROI measurements were also performed in AC scans in which SPECT and CT images had been misaligned by 1 cm in one dimension beforehand (ACX, ACY, ACZ). Results: After AC, DPD uptake ratios differed significantly from the NAC values in all regions studied ranging from 32% for the left facet joint to 39% for the vertebral body. AC using misaligned pairs of patient data sets led to a significant change of whole-slice uptake ratios whose differences ranged from 3,5 to 25%. For ACX, the average left-to-right ratio of the facet joints was by 8% and for the superior iliacal spines by 31% lower than the values determined for the matched images (p <0.05). Conclusions: AC significantly affects DPD uptake ratios. Furthermore, misalignment between SPECT and CT may introduce significant errors in quantification, potentially also affecting leftto- right ratios. Therefore, at clinical evaluation of attenuation- corrected scans special attention should be given to possible misalignments between SPECT and CT.

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