Filum terminale schwannoma with new onset of severe low back pain and radiculopathy: illustrative case.

Justin N Passman, Emily H Stack, Robert S Kleyner, John Servider, Emily Bellow, Roberta Seidman, Harry Mushlin
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Abstract

Background: Schwannomas are CNS WHO grade 1 benign peripheral nerve sheath tumors. They can occur anywhere in the body where there are peripheral nerves, but they are most common in the vestibular system. To the authors' knowledge, there has been only one previous report of their presentation in the filum terminale.

Observations: The author present the case of a 36-year-old man who presented to the emergency department with acute-on-chronic right low back pain and shooting pain to his right groin with radiation to his knee. He was found to have an L1-2 intradural extramedullary lesion on MRI abutting the conus. His preoperative neurological examination was otherwise unremarkable, and he was promptly taken for L1-2 laminectomy and resection of the lesion. Final pathological diagnosis was intradural extramedullary cellular schwannoma, CNS WHO grade 1, of the filum terminale. Postoperative MRI demonstrated gross-total resection. The patient had new urinary fullness and constipation, which resolved by the 2-month follow-up, and otherwise recovered well with resolution of his back and leg pain.

Lessons: This case illustrates a rare presentation of an intradural extramedullary cellular schwannoma at the filum terminale, emphasizing the importance of a broad differential diagnosis. Resection of these neoplasms offers a definitive and safe treatment. https://thejns.org/doi/10.3171/CASE25333.

末丝神经鞘瘤伴新发严重腰痛和神经根病:说明性病例。
背景:神经鞘瘤是中枢神经系统WHO一级良性周围神经鞘肿瘤。它们可以发生在身体任何有周围神经的地方,但它们最常见于前庭系统。据作者所知,只有一个以前的报道,他们的表现在终末片。观察:作者提出了一个病例36岁的男子谁提出了急诊科急性慢性右腰痛和射击痛,他的右腹股沟与放射到他的膝盖。在MRI上发现他有一个L1-2硬膜内髓外病变,靠近圆锥。术前神经学检查无异常,立即行L1-2椎板切除术和病变切除。最终病理诊断为硬膜内髓外细胞神经鞘瘤,CNS WHO分级1级。术后MRI显示大体全切除。患者新发尿多和便秘,随访2个月后消失,其他方面恢复良好,背部和腿部疼痛缓解。经验教训:本病例罕见地表现为硬膜内髓外细胞神经鞘瘤,强调广泛鉴别诊断的重要性。切除这些肿瘤是一种明确和安全的治疗方法。https://thejns.org/doi/10.3171/CASE25333。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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