Acute paraplegia due to thoracolumbar schwannoma following trauma: A case report and literature review

Karabetsos,Dimitris A.; Tsitsipanis,Christos; Koutserimpas,Christos; Chaniotis,Vrettos; Vakis,Antonios; Samonis,George; Alpantaki,Kalliopi

doi:10.3892/mco.2021.2366

Acute paraplegia due to thoracolumbar schwannoma following trauma: A case report and literature review

Authors:
- Dimitris A. Karabetsos
- Christos Tsitsipanis
- Christos Koutserimpas
- Vrettos Chaniotis
- Antonios Vakis
- George Samonis
- Kalliopi Alpantaki
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Affiliations: Department of Neurosurgery, University Hospital of Crete, Heraklion 71500, Greece, Department of Orthopaedics and Traumatology, ‘251’ Hellenic Air Force General Hospital of Athens, Athens 11525, Greece, Department of Pathology, General Hospital of Chania, Chania 73300, Greece, Department of Internal Medicine, University Hospital of Crete, Heraklion 71500, Greece, Department of Orthopaedics and Trauma, Venizeleion General Hospital of Heraklion, Heraklion 71409, Greece
Published online on: August 8, 2021 https://doi.org/10.3892/mco.2021.2366
Article Number: 204

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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.

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