Treatment of large thoracic and lumbar paraspinal schwannoma
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Treatment of large thoracic and lumbar paraspinal schwannoma. / Krätzig, Theresa; Dreimann, Marc; Klingenhöfer, Mark; Floeth, Frank W; Krajewski, Kara; Eicker, Sven O.
In: ACTA NEUROCHIR, Vol. 157, No. 3, 01.03.2015, p. 531-8.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Treatment of large thoracic and lumbar paraspinal schwannoma
AU - Krätzig, Theresa
AU - Dreimann, Marc
AU - Klingenhöfer, Mark
AU - Floeth, Frank W
AU - Krajewski, Kara
AU - Eicker, Sven O
PY - 2015/3/1
Y1 - 2015/3/1
N2 - BACKGROUND: Paraspinal neurogenic tumors usually expand into the mediastinum and retroperitoneum and can reach a considerable size before they become symptomatic. Such large tumors are rare. We describe 14 cases of large schwannomas (>2.5 cm ø) with mild and late onset of symptoms, which were treated with total surgical resection through a single-approach surgery.METHODS: In 2013 14 patients with paraspinal large schwannomas were treated in our institutions. Data were analyzed retrospectively. Magnetic resonance imaging (MRI) showed lesions suspicious for a paraspinal schwannoma with partial intraforaminal growth. In case of ambiguity regarding tumor dignity, a needle biopsy was performed before final treatment. Three different approaches and their indications were discussed.RESULTS: Fourteen patients (7 female and 7 male, ages 18-58 years, mean: 39.8 years) requiring surgical exploration because of a thoracic (6) or lumbar/lumbosacral (8) lesion were treated in our institutions. Two patients received CT-guided needle biopsy preoperatively. Complete resection of the schwannoma was possible through a mini-thoracotomy in 1 case (7 %), a retroperitoneal approach in 2 cases (14 %), and dorsal interlaminar and intercostal fenestration in 11 cases (79 %). Histological examination revealed the diagnosis of schwannoma (WHO grade I) in all cases except one with neurofibroma (WHO grade I). There were no major complications in any case.CONCLUSION: Large benign schwannomas are rare. They need a tailored treatment, which in most cases works through one surgical approach. Usually it is possible to perform a complete resection with a good postoperative prognosis.
AB - BACKGROUND: Paraspinal neurogenic tumors usually expand into the mediastinum and retroperitoneum and can reach a considerable size before they become symptomatic. Such large tumors are rare. We describe 14 cases of large schwannomas (>2.5 cm ø) with mild and late onset of symptoms, which were treated with total surgical resection through a single-approach surgery.METHODS: In 2013 14 patients with paraspinal large schwannomas were treated in our institutions. Data were analyzed retrospectively. Magnetic resonance imaging (MRI) showed lesions suspicious for a paraspinal schwannoma with partial intraforaminal growth. In case of ambiguity regarding tumor dignity, a needle biopsy was performed before final treatment. Three different approaches and their indications were discussed.RESULTS: Fourteen patients (7 female and 7 male, ages 18-58 years, mean: 39.8 years) requiring surgical exploration because of a thoracic (6) or lumbar/lumbosacral (8) lesion were treated in our institutions. Two patients received CT-guided needle biopsy preoperatively. Complete resection of the schwannoma was possible through a mini-thoracotomy in 1 case (7 %), a retroperitoneal approach in 2 cases (14 %), and dorsal interlaminar and intercostal fenestration in 11 cases (79 %). Histological examination revealed the diagnosis of schwannoma (WHO grade I) in all cases except one with neurofibroma (WHO grade I). There were no major complications in any case.CONCLUSION: Large benign schwannomas are rare. They need a tailored treatment, which in most cases works through one surgical approach. Usually it is possible to perform a complete resection with a good postoperative prognosis.
U2 - 10.1007/s00701-014-2320-5
DO - 10.1007/s00701-014-2320-5
M3 - SCORING: Journal article
C2 - 25577451
VL - 157
SP - 531
EP - 538
JO - ACTA NEUROCHIR
JF - ACTA NEUROCHIR
SN - 0001-6268
IS - 3
ER -