TITLE:
Paraspinal Intramuscular Schwannoma: Case Presentation and Literature Review of a Rare Pathology
AUTHORS:
Daniele Valsecchi, Julien Galley, Simone Verzellotti, Alexandre Dontschev, Pablo Mondragon, Philippe Otten, Gianluca Maestretti
KEYWORDS:
Intramuscular Mass, Paraspinal Tumour, Ancient Schwannoma, Split Fat Sign
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.3,
June
16,
2022
ABSTRACT: Background: A pure intramuscular paraspinal schwannoma is
extremely rare, with only few case reports in the literature. Due to low
frequency, lack of specific clinical signs and symptoms and difficult
radiological assessment, the pre-surgical workup leads to a broad differential
diagnosis. The aim of the work carried out was therefore to search for evidence
of common clinical and radiological signs of the intramuscular paraspinal
schwannoma, useful in the diagnostic work-up, and to highlight possible
standards of treatment. Methods: Starting from the analysis of our case, we have
extended a search to similar cases on the databases PubMed and Google Scholar.
The outcome of the analysis gathered, up to August 2021, six relevant papers. Result: We treated a 69-year-old female with a thoracic
intramuscular paraspinal mass. The pre-operative MRI had identified two typical
signs of schwannoma (“split-fat” sign and the “entry-exit” sign). Intraoperative nerve
isolation was performed and complete surgical excision was achieved. At the
pathological analysis, we could confirm a rare OMS grade I “ancient
schwannoma”. The analysis of the literature data showed a homogeneous picture
of radiological presentation of the pathology. Moreover, surgical treatment was
always the treatment of choice. Conclusions: The proposed assessment and treatment were
consistent with the standard collected in the literature. Typical radiological
signs were also found in the other cases collected. Radical surgery is the
preferred treatment.