Extrathecal intraradicular nerve sheath tumor

2005 ◽  
Vol 3 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Paolo Celli ◽  
Giuseppe Trillò ◽  
Luigi Ferrante
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
En Bloc ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Radical Removal ◽  
Fine Print

Object. The purpose of this study was to analyze the clinical profile of patients harboring extrathecal and intraradicular nerve sheath tumors (NSTs), located inside the sleeve of an extrathecal nerve root and very often within the proximal portion of the spinal nerve, and to evaluate the incidence of long-term dysfunction of the tumor-affected roots if resected. These tumors have not received particular attention in the literature. Methods. A single-institution series of 16 patients who had undergone surgery for intraradicular NSTs during a 50-year period was selected retrospectively. Data pertaining to clinical features, tumor characteristics, and results of surgery were analyzed. Conclusions. Extrathecal and intraradicular neurofibromas or schwannomas more frequently affect the lumbar and S-1 nerve roots, often producing root pain only. Selective en bloc enucleation sparing at least part of the motor rootlets is possible for small schwannomas of the extrathecal—preganglion segment of the radix, whereas total resection of the affected root is generally required for radical removal of neurofibromas and large schwannomas. In the authors' experience, neither deafferentation pain nor severe radicular weakness occurs after division of the nerve root harboring the tumor.

Spinal extradural schwannoma

2005 ◽  
Vol 2 (4) ◽  
pp. 447-456 ◽  
Author(s):  
Paolo Celli ◽  
Giuseppe Trillò ◽  
Luigi Ferrante
Keyword(s):  
Nerve Root ◽  
Pyramidal Tract ◽  
Tumor Resection ◽  
Spinal Nerve ◽  
Cervical Region ◽  
Nerve Roots ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Fine Print

Object. The authors endeavor to define the clinical and surgery-related profile of spinal nerve sheath tumors located in the extradural space outside both the dural sac and, apparently, the nerve roots' sleeve. Methods. A series of 24 extradural schwannomas was retrospectively selected after reviewing the notes of spinal nerve sheath tumors surgically treated at La Sapienza University of Rome. Clinical data, tumor-related characteristics, and outcome were analyzed. Women predominantly harbored these tumors. On admission sensory nerve root dysfunction was infrequently reported, whereas pyramidal tract deficits were often present. The tumor, generally large, was most frequently located in the intermediate thoracic segments and high cervical region; only one was reported in the lumbosacral region. Considerable erosion of vertebral bodies was reported in almost one third of the cases. In four patients eloquent nerve roots, that of C-5 in three and that of S-1 in one, were involved with the tumor. Radical tumor resection, with preservation of the nerve roots, was possible in several cases, whereas in two patients manipulation and resection of the C-5 root produced transient and permanent, respectively, root palsy. At follow-up examination patients for whom walking was impossible before surgery were now able to walk. Conclusions. Extradural schwannomas can be distinguished from other nerve sheath tumors growing inside the spinal canal by their clinicoradiological features and unlikely nerve root origin. After surgery, recovery from pyramidal tract deficits, even severe, is noteworthy; in the authors' experience, however, resection of an involved appendicular root is more likely to result in a permanent and significant radicular deficit.

Clinical Characteristics of Spinal Nerve Sheath Tumors: Analysis of 149 Cases

Neurosurgery ◽  
2005 ◽  
Vol 56 (3) ◽  
pp. 510-515 ◽  
Author(s):  
Takahiro Jinnai ◽  
Minoru Hoshimaru ◽  
Tsunemaro Koyama
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
Spinal Nerve Root ◽  
Intervertebral Foramen ◽  
Nerve Roots ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Caudal Portion ◽  
Rostral Portion

Abstract OBJECTIVE: Spinal nerve sheath tumors arise from the spinal nerve root and grow along it. There are two sites at which the growth of a tumor is restricted: the dural aperture for the spinal nerve root and the intervertebral foramen. This article describes the growth pattern of a spinal nerve sheath tumor along the spinal nerve root at various spinal levels. METHODS: We retrospectively reviewed the records for 149 patients with spinal nerve sheath tumors who were treated between 1980 and 2001. Of these, 176 resected tumors were classified into five groups according to the relationship to the dura mater and/or the intervertebral foramen. RESULTS: Strictly intradural tumors compose 8% of nerve sheath tumors of the first two cervical nerve roots. The percentage of these tumors increased gradually from the high cervical region to the thoracolumbar region, where it was more than 80%. In contrast, the percentage of strictly extradural tumors gradually decreased from the rostral portion to the caudal portion. Similarly, a percentage of tumors extending outside the spinal canal decreased from the rostral portion to the caudal portion. These changes of the growth pattern may be explained by the anatomic features of the spinal nerve roots, which have a longer intradural component at the more caudal portion of the spinal axis. CONCLUSION: The anatomic relationship of a nerve sheath tumor with the dura mater and the intervertebral foramen varies depending on the level of the tumor. This knowledge may help us to create a strategy for total resection of a nerve sheath tumor.

scholarly journals Melanotic Schwannoma of the Vagina: A Report of a Very Rare Tumor and Review of the Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Kofi Effah ◽  
Stefan Seidl ◽  
Edith Gorges ◽  
Patrick Kafui Akakpo
Keyword(s):  
Carney Complex ◽  
Spinal Nerve ◽  
Nerve Sheath Tumor ◽  
Nerve Roots ◽  
Melanotic Schwannoma ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Long Term Follow Up

Melanotic schwannoma (MS) is a rare nerve sheath tumor with fewer than 200 cases reported. MS has uncertain malignant potential and comprises 1% of all nerve sheath tumors with a predilection for the spinal nerve roots. An even rarer location for this tumor is the vagina. Up to 55% of MSs that contain psammoma bodies are associated with the Carney complex, an autosomal dominant syndrome. Criteria for malignancy in MS are still not well established and long term follow-up of patients is recommended. A 26-year-old woman presented with a bleeding vaginal tumor which was diagnosed as MS following excision. The clinical, histopathological, and immunohistochemical features of this tumor are discussed.

Benign spinal nerve sheath tumors: their occurrence sporadically and in neurofibromatosis types 1 and 2

1991 ◽  
Vol 74 (2) ◽  
pp. 248-253 ◽  
Author(s):  
Andrea L. Halliday ◽  
Raymond A. Sobel ◽  
Robert L. Martuza
Keyword(s):  
Neurofibromatosis Type 1 ◽  
Neurofibromatosis Type ◽  
Spinal Nerve ◽  
Neurofibromatosis Type 2 ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Fine Print

✓ Benign spinal nerve sheath tumors (neurofibromas and schwannomas) often occur on dorsal nerve roots sporadically or in neurofibromatosis types 1 and 2. These are histologically benign tumors, and distinction between them is frequently not made by clinicians. To determine if there is a correlation between the histological pattern of benign spinal nerve sheath tumors and the type of neurofibromatosis, the clinical and pathological features of these tumors (86 surgical specimens and five autopsies) in 68 patients were reviewed. The patients were classified into one of four categories: neurofibromatosis type 1, neurofibromatosis type 2, uncertain, or sporadic. The diagnostic criteria used for neurofibromatosis types 1 and 2 were established by the National Institutes of Health. Patients who did not fulfill criteria for either neurofibromatosis type 1 or 2 but who had multiple nervous system tumors or other stigmata of neurofibromatosis were designated “uncertain.” Spinal nerve sheath tumors were considered sporadic in 42 cases (40 schwannomas and two neurofibromas). In the 14 patients with neurofibromatosis type 1, all spinal nerve sheath tumors were neurofibromas. In six of the seven patients with neurofibromatosis type 2, all spinal nerve sheath tumors were schwannomas. One patient with neurofibromatosis type 2 had a spinal nerve sheath schwannoma and a tumor with features of both tumor types. The authors conclude that spinal nerve sheath tumors in patients with neurofibromatosis type 1 are neurofibromas. In contrast, spinal nerve sheath tumors occurring in neurofibromatosis type 2 or sporadically are most frequently schwannomas. The distinct histological features of these tumors may reflect different pathogenetic mechanisms even though they arise at identical sites in neurofibromatosis types 1 and 2.

Dumbbell Nerve Sheath Tumors

2018 ◽  
Author(s):  
Hussam Abou-Al-Shaar ◽  
Mark A. Mahan
Keyword(s):  
Imaging Modality ◽  
Spinal Nerve ◽  
Surgical Approaches ◽  
Nerve Sheath Tumor ◽  
Imaging Features ◽  
Neural Foramen ◽  
Dumbbell Tumor ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
The Individual

A dumbbell tumor is a nerve sheath tumor that arises from a spinal nerve in the neural foramen and grows as a dumbbell-shaped mass. The differential diagnosis for a dumbbell tumor includes schwannoma, neurofibroma, malignant peripheral nerve sheath tumor, and metastases, among others. MR imaging is considered the gold-standard imaging modality for diagnosis of dumbbell tumors. Surgical approaches that are tailored to the individual patient’s case can be utilized. The chapter reviews dumbbell tumors, including a case example and covers the incidence, clinical presentation, imaging features, decision-making strategy, surgical approaches, outcomes, and potential complications associated with their management.

Spinal malignant nerve-sheath tumor or cellular schwannoma? A striking difference in prognosis

1993 ◽  
Vol 79 (4) ◽  
pp. 528-532 ◽  
Author(s):  
Matti T. Seppälä ◽  
Matti J. J. Haltia
Keyword(s):  
Malignant Tumors ◽  
Spinal Tumors ◽  
Striking Difference ◽  
Malignant Neoplasms ◽  
Nerve Sheath Tumor ◽  
Content Type ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
Cellular Schwannoma ◽  
S 100

✓ Cellular schwannoma, a recently delineated entity, has a histological appearance mimicking that of malignant neoplasms. The aim of this study was to determine the outcome for patients treated for a spinal cellular schwannoma or malignant nerve-sheath tumor. A histological re-examination was conducted of 283 spinal tumors, considered to originate from a nerve root, that were treated in the Department of Neurosurgery between 1953 and 1985. After re-examination, 50 of these were determined to be other tumors or nonneoplastic lesions. The review yielded eight cellular schwannomas and six malignant nerve-sheath tumors out of 233 of nerve-sheath origin. Immunohistochemical staining with a commercially available polyclonal antibody against S-100 protein was positive in all cases of cellular schwannoma, but negative for the malignant tumors. Clinical outcome was favorable for patients with cellular schwannomas, but uniformly poor for those with the malignant tumors.

Malignant intracerebral nerve sheath tumor with intratumoral calcification

2000 ◽  
Vol 92 (2) ◽  
pp. 338-341 ◽  
Author(s):  
Minoru Tanaka ◽  
Soichiro Shibui ◽  
Kazuhiro Nomura ◽  
Yukihiro Nakanishi ◽  
Tadashi Hasegawa ◽  
...  
Keyword(s):  
Nerve Sheath Tumor ◽  
Pathological Features ◽  
Resonance Imaging ◽  
Content Type ◽  
Nerve Sheath ◽  
First Case ◽  
The Right ◽  
Tomography Scanning ◽  
Considerable Enhancement ◽  
Fine Print

✓ The authors present the clinical, radiological, and pathological features of a malignant intracerebral nerve sheath tumor that occurred in the right parietooccipital lobe of a 4-year-old girl. Computerized tomography scanning and magnetic resonance imaging demonstrated a 5 × 5 × 4—cm multiloculated mass with considerable enhancement of the irregularly shaped septa and clearly calcified areas within the mass. Among five cases reported in the literature, this patient is the youngest and represents the first case in which there is radiological evidence of intratumoral calcification.

Infiltrating ependymomas of the cauda equina

1974 ◽  
Vol 41 (4) ◽  
pp. 446-448 ◽  
Author(s):  
Michael Scott
Keyword(s):  
Cauda Equina ◽  
Conservative Surgery ◽  
Long Term Results ◽  
Content Type ◽  
Radical Removal ◽  
Benign Course ◽  
Fine Print

✓ The author reports the long-term results of combined conservative surgery and radiotherapy in the treatment of three patients with infiltrating papillary ependymomas Of the cauda equina. Seventeen to 20 years later they have relatively minimal complaints and dysfunction. This long benign course emphasizes the folly of attempting radical removal with its potential for serious mutilation of the cauda equina.

Mechanisms of cervical nerve root avulsion in injuries of the neck and shoulder

1974 ◽  
Vol 41 (6) ◽  
pp. 705-714 ◽  
Author(s):  
Sydney Sunderland
Keyword(s):  
Nerve Root ◽  
Spinal Nerve ◽  
Spinal Nerve Root ◽  
Root Avulsion ◽  
Cervical Nerve Root ◽  
Cervical Nerve ◽  
Content Type ◽  
Nerve Root Avulsion ◽  
New Interpretation ◽  
Fine Print

✓ The author reviews the mechanisms of traumatic spinal nerve root avulsion and proposes a new interpretation.

Melanotic nerve sheath tumors

1974 ◽  
Vol 41 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Thaddeus I. Mandybur
Keyword(s):  
Normal Skin ◽  
Cord Compression ◽  
Radicular Pain ◽  
Nerve Sheath Tumor ◽  
Melanin Production ◽  
Content Type ◽  
Histological Features ◽  
Nerve Sheath Tumors ◽  
Nerve Sheath ◽  
History Of

✓ A solitary intraspinal, extradural melanotic tumor was subtotally resected in a 59-year-old man who had a 17-year history of radicular pain and later evidence of progressive spinal cord compression. The neoplasm revealed the histological features of a benign nerve sheath tumor with massive but uneven melanin production. In electron micrographs the tumor cells contained masses of melanosomes of the type seen in normal skin melanocytes and in B type melanocarcinomas. In the 16-month postoperative period there has been only minimal radiological indication of local recurrence and no metastases.

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