Case Reports
doi: 10.3892/mco.2021.2366.
Epub 2021 Aug 8.
Affiliations
Affiliations
- 1 Department of Neurosurgery, University Hospital of Crete, Heraklion 71500, Greece.
- 2 Department of Orthopaedics and Traumatology, ‘251’ Hellenic Air Force General Hospital of Athens, Athens 11525, Greece.
- 3 Department of Pathology, General Hospital of Chania, Chania 73300, Greece.
- 4 Department of Internal Medicine, University Hospital of Crete, Heraklion 71500, Greece.
- 5 Department of Orthopaedics and Trauma, Venizeleion General Hospital of Heraklion, Heraklion 71409, Greece.
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Case Reports
Dimitris A Karabetsos et al.
Mol Clin Oncol.
2021 Oct.
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doi: 10.3892/mco.2021.2366.
Epub 2021 Aug 8.
Affiliations
- 1 Department of Neurosurgery, University Hospital of Crete, Heraklion 71500, Greece.
- 2 Department of Orthopaedics and Traumatology, ‘251’ Hellenic Air Force General Hospital of Athens, Athens 11525, Greece.
- 3 Department of Pathology, General Hospital of Chania, Chania 73300, Greece.
- 4 Department of Internal Medicine, University Hospital of Crete, Heraklion 71500, Greece.
- 5 Department of Orthopaedics and Trauma, Venizeleion General Hospital of Heraklion, Heraklion 71409, Greece.
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Abstract
Spinal schwannomas account for one third of primary spinal neoplasms. Clinical presentation is related to the tumor location. An atypical case of acute paraplegia following a fall, on the ground of a thoracolumbar schwannoma, without intratumoral hemorrhage, in a previously asymptomatic patient is reported. A 58-year-old male patient presented with acute paraplegia, and urinary and bowel incontinence, following a fall. The patient had no previous history of back and/or leg pain or neurological symptoms. Magnetic resonance imaging revealed a subdural mass, as well as a fracture of the right T12-L1 facet joint and the right transverse process. The patient underwent emergency T11-L1 wide laminectomy, exploration of the subdural space and T10-L2 posterolateral transpedicular stabilization and fusion. An intradural, extramedullary mass, causing severe cord compression, was found and excised. Pathology revealed schwannoma, without intratumoral hemorrhage. The patient recovered completely 6 months postoperatively. To the best of our knowledge, this is the first report of spinal intradural schwannoma causing sudden paraplegia in a previously asymptomatic patient in the setting of trauma, without intratumoral hemorrhage. Emergency canal decompression and complete excision of the tumor represent the optimal management of such cases.
Keywords:
intratumoral hemorrhage; lumbar spine; paraplegia; schwannoma; spinal tumor.
Copyright © 2020, Spandidos Publications.
Conflict of interest statement
The authors declare that they have no competing interests.
Figures

Figure 1
Emergency pre-operative MRI revealed a…
Figure 1
Emergency pre-operative MRI revealed a subdural mass at the T12-L1 level limited to…
Figure 1
Emergency pre-operative MRI revealed a subdural mass at the T12-L1 level limited to the subdural space, without extension to the pedicle (sagittal and axial view). The arrows indicate the subdural mass. MRI, magnetic resonance imaging.

Figure 2
Peripheral section of the cellular…
Figure 2
Peripheral section of the cellular area (Antoni A) of Schwannoma with numerous Verocay…
Figure 2
Peripheral section of the cellular area (Antoni A) of Schwannoma with numerous Verocay bodies (H&E stain). a, peripheral bleeding due to the removal handling or excision handling; b, blood vessels; and arrows, Verocay bodies. Scale bar, 1 mm. H&E, hematoxylin and eosin.

Figure 3
Comparative MRI revealed complete restoration…
Figure 3
Comparative MRI revealed complete restoration of the spinal canal. (A) Preoperative, (B) 6…
Figure 3
Comparative MRI revealed complete restoration of the spinal canal. (A) Preoperative, (B) 6 months, and (C) 44 months postoperative. MRI, magnetic resonance imaging.
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