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Paraspinal Intramuscular Schwannoma: Case Presentation and Literature Review of a Rare Pathology

Paraspinal Intramuscular Schwannoma: Case Presentation and Literature Review of a Rare Pathology

作     者:Daniele Valsecchi Julien Galley Simone Verzellotti Alexandre Dontschev Pablo Mondragon Philippe Otten Gianluca Maestretti Daniele Valsecchi;Julien Galley;Simone Verzellotti;Alexandre Dontschev;Pablo Mondragon;Philippe Otten;Gianluca Maestretti

作者机构:Neuro-Spinal Unit Department of Orthopedic Surgery and Traumatology Hô pital Fribourgeois—HFR University of Fribourg Fribourg Switzerland Department of Radiology Hô pital Fribourgeois—HFR University of Fribourg Fribourg Switzerland Faculty of Science and Medicine University of Fribourg Fribourg Switzerland Chronic Pain Unit Department of Anesthesiology Hô pital Fribourgeois—HFR University of Fribourg Fribourg Switzerland 

出 版 物:《Open Journal of Modern Neurosurgery》 (现代神经外科学进展(英文))

年 卷 期:2022年第12卷第3期

页      面:117-126页

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主  题:Intramuscular Mass Paraspinal Tumour Ancient Schwannoma Split Fat Sign 

摘      要: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.

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