Giant Sacral Schwannoma Treated with a 360 Approach: A Rare Case and Systematic Review of the Literature
| Autor: | Ghiath Ismayl, Ursalan Ahmed Khan, Irfan Malik |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Abdominal pain medicine.medical_specialty Sacrum Nerve root medicine.medical_treatment Schwannoma Pelvis 03 medical and health sciences 0302 clinical medicine Laparotomy medicine Humans Spinal canal Spinal Neoplasms business.industry medicine.disease Magnetic Resonance Imaging Nerve sheath tumor medicine.anatomical_structure 030220 oncology & carcinogenesis Surgery Neurology (clinical) Radiology medicine.symptom business Tomography X-Ray Computed 030217 neurology & neurosurgery Neurilemmoma |
| Zdroj: | World neurosurgery. 115 |
| ISSN: | 1878-8769 |
| Popis: | Background Sacral schwannomas are very rare and typically have a benign nature. They occur in a permissive anatomical location leading to nonspecific symptoms that can result in them going unnoticed before reaching a considerable size. Case Description We report a rare case of a giant sacral schwannoma (130 × 110 × 90 mm) in a 38-year-old man originating from the S2 nerve root, encompassing the neural canal with sacral erosion and extension in to the pelvis. The patient presented with a history of abdominal pain associated with increased urinary frequency and a sensation of incomplete bladder emptying. Magnetic resonance imaging demonstrated a giant pelvic mass with sacral erosion and involvement of the nerve roots. Subsequently, he went on to have a 2-stage procedure in which complete resection of the schwannoma was achieved by both a posterior hemilaminectomy and laparotomy with the aid of neuromonitoring. The postoperative course was uneventful, with complete resolution of symptoms. Conclusions We report one of the largest benign sacral schwannoma originating inside the spinal canal with pelvic extension to be resected without complications. We discuss our successful management and conduct a systematic review of the literature to provide the most up to date guidance on managing this tumor, including the application of neuromonitoring and a 360 approach in 2 stages. |
| Databáze: | OpenAIRE |
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