Intramedullary Schwannoma of Cervical Spinal Cord Presenting Inconspicuous Enhancement with Gadolinium

World Neurosurg. 2019 Jul:127:418-422. doi: 10.1016/j.wneu.2019.04.118. Epub 2019 Apr 25.

Abstract

Background: Intramedullary schwannomas of the spinal cord are extremely rare. Most previous studies are case reports, which have found that intramedullary schwannomas could be homogeneous or asymmetrically enhanced with gadolinium. However, intramedullary schwannomas with minimal enhancement have not been reported.

Case description: This article describes a 34-year-old patient who presented with nonradiative neck pain, progressive weakness of the left limbs, and sensory deficit of both lower extremities. Preoperative examinations such as magnetic resonance imaging (MRI) were performed, and the patient underwent surgical treatment. MRI showed that the lesion presented unsharp enhancement with gadolinium on T1-weighted images. Histopathologic findings were consistent with the diagnosis of schwannoma.

Conclusions: We report a case of intramedullary schwannoma that presented inconspicuous enhancement with gadolinium. MRI is useful but cannot be used to differentiate schwannomas from other intramedullary spinal tumours. Surgical resection is the most vital factor for the treatment of intramedullary schwannoma.

Keywords: Intramedullary schwannomas; Magnetic resonance imaging; Spinal cord; Surgical resection.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cervical Cord / diagnostic imaging*
  • Cervical Cord / surgery
  • Gadolinium*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Male
  • Neurilemmoma / diagnostic imaging*
  • Neurilemmoma / surgery
  • Spinal Cord Neoplasms / diagnostic imaging*
  • Spinal Cord Neoplasms / surgery

Substances

  • Gadolinium