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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery
DOI: 10.1055/s-0042-1744111
Case Report

Multiple Medullary Schwannoma Associated with Lumbar Disc Herniation and Cauda Equina Syndrome: Case Report

Schwannoma medular múltiplo associado a hérnia de disco lombar e síndrome da cauda equina: Relato de caso
Anibal Rodrigues Neto 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Bianca Bicalho 
2   Medicine Program, Pontifícia Universidade Católica do Paraná, PR, Brazil
,
Giovanna Maria Varandas 
2   Medicine Program, Pontifícia Universidade Católica do Paraná, PR, Brazil
,
Adriano Torres Antonucci 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Gabriel Gomes Freitas de Castro 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Shiro Manoel Shimoakoishi de Arruda 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Marcel Schiavini 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Lutero Cleuler Moraes dos Santos 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Márcio Francisco Lehmann 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
,
Francisco Spessatto Pesente 
1   Department of Clinical Surgery – Neurosurgery, Universidade Estadual de Londrina, Londrina, PR, Brazil
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Abstract

Introduction Schwannoma is a Schwann cells neoplasm that can occur in various parts of the nervous system, including the medullar region of the cauda equina. Bone involvement is uncommon.

Objective To report a multiple schwannoma case that was initially diagnosed as cauda equina syndrome.

Clinical Case We report the case of a 44-year-old male who presented with pain irradiating to the lower limbs, urinary retention, and saddle paresthesia. Imaging exams revealed tumors in the cervical spine and in the T12/L1, L2/L3, and L3/L4 levels, the last three causing nervous compression. Histopathological analyses confirmed a Schwannoma pattern.

Results The case was solved by surgical resection.

Conclusion The case was solved and, in the end, the patient was stable and with improved pain and waits for a cervical surgery.

Resumo

Introdução Schwannoma é uma neoplasia de células de Schwann que pode ocorrer em diversas partes do sistema nervoso, incluindo a região medular da cauda equina. O acometimento ósseo é incomum.

Objetivo Relatar um caso de schwannoma múltiplo que foi diagnosticado inicialmente como síndrome da cauda equina.

Relato de caso Relatamos o caso de um paciente masculino de 44 anos que apresentou quadro álgico com irradiação para os membros inferiores, retenção urinária e parestesia em cela. Exames de imagem revelaram tumores na cervical e em níveis de T12/L1, L2/L3 e L3/L4, com os três últimos causando compressão nervosa. A análise histopatológica comprovou padrão de schwannoma.

Resultados A correção do quadro se deu através da ressecção cirúrgica.

Conclusão O quadro foi resolvido com o paciente apresentando-se estável e com melhora do quadro álgico. O paciente aguarda cirurgia a nível cervical.

Keywords

schwannoma - neoplasm - lumbalgia

Palavras-chave

schwannoma - neoplasia - lombalgia

Ethics Statement

In the present case report, neither the patient nor any of his data have been identified.




Publication History

Received: 16 September 2021

Accepted: 18 January 2022

Article published online:
10 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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