Unusual Anterior Neck Swelling: Cervical Spinal Cord Schwannoma

Abstract

Schwannomas are typically solitary, well-encapsulated, benign tumors running along or attached to a nerve. An intradural-extramedullary cervical spinal schwannoma, which first manifests as a swelling in the anterior neck, has not been reported to the best of our knowledge. We present the case of a 69-year-old patient complaining of a gradually worsening painful left cervical swelling for over 8 years. First, a posterior spinal midline approach was performed for the resection of the tumor and the tumor portion in the vertebral canal was totally removed. The second operation, the anterolateral approach, was planned to be executed in a second surgical session. The patient was discharged from the hospital without neurological deficits. Histopathological diagnosis was a schwannoma. The first aim of surgery is to treat neurological deficits in patients with cervical intraspinal schwannomas with/without extension into the extra-vertebral paravertebral neck regions. The surgical strategy combines the posterior midline and the anterolateral cervical approaches in the same session or at different times.

Resumo

Schwannomas são tipicamente tumores solitários, bem encapsulados e benignos que correm ao longo ou aderem a um nervo. Até onde sabemos, um schwannoma espinhal cervical intradural-extramedular que se manifesta pela primeira vez como um inchaço na região anterior do pescoço não foi relatado. Apresentamos o caso de um paciente de 69 anos com queixa de inchaço cervical esquerdo doloroso de piora gradual há mais de 8 anos. Primeiramente, uma abordagem da linha média da coluna vertebral posterior foi realizada para a ressecção do tumor, e a porção do tumor no canal vertebral foi totalmente removida. A segunda operação, via anterolateral, foi planejada para ser realizada em uma segunda sessão cirúrgica. O paciente recebeu alta hospitalar sem déficits neurológicos. O diagnóstico histopatológico foi um schwannoma. O primeiro objetivo da cirurgia é tratar déficits neurológicos em pacientes com schwannomas intraespinhais cervicais com/sem extensão para as regiões extravertebrais do pescoço paravertebral. A estratégia cirúrgica combina a abordagem da linha média posterior e a abordagem anterolateral cervical na mesma sessão ou em momentos diferentes.

Keywords

cervical neuroma - dumbbell schwannoma - neck mass - neck swelling - spinal schwannoma

Palavras-chave

neuroma cervical - schwannoma com halteres - massa cervical - inchaço do pescoço - schwannoma espinhal

Ethical Issues

The ethical issues for the present study involving human subjects have been carefully considered in line with the Declaration of Helsinki (1964).

Financial Support

None.

Authors' Contributions

Erkin Özgiray: Conceived the idea, collected data, performed the analysis, interpreted the results, wrote the text, performed a literature search, critically reviewed the intellectual content, and revised the text.

Cihat Karagöz: Analyzed and designed data, interpreted the results, performed a literature search, revised the text, and critically reviewed the intellectual content.

Serdar Bölük: Analyzed and designed data, interpreted the results, performed a literature search, and revised the text.

Naci Balak: Analyzed and designed data, interpreted the results, performed a literature search, revised the text, and critically reviewed the intellectual content.

Patient Consent

The patient signed the informed consent agreement of clinical images and data for medical use.

Publication History

Received: 01 May 2021

Accepted: 06 August 2021

Article published online:
13 December 2021

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