STUDY DESIGN: Case report. OBJECTIVE: To describe the clinical and radiographic features of an extremely rare case with intra-extradural plexiform schwannoma of the cervical spine. SUMMARY OF BACKGROUND DATA: Plexiform schwannoma is a rare neurogenic tumor that predominantly occurs in the dermis and subcutis. Noncutaneous deep-seated lesions have rarely been described. No cases of intra-extradural plexiform schwannoma of the cervical spine have previously been reported. METHODS: A 16-year-old boy presented with a 3-month history of left neck and shoulder angle pain, motor weakness of the left upper extremity, clumsiness of bilateral hands, and mild gait disturbance. Preoperative magnetic resonance imaging showed a multinodular inhomogeneous dumbbell-shaped tumor encroaching on the cord at C3-C4. T1-weighted imaging showed the tumor as inhomogeneous with slightly higher intensity than muscle. T2-weighted imaging demonstrated a multinodular inhomogeneous tumor with much higher intensity than muscle, and each nodule of the tumor displayed a peripheral rim of higher intensity and central relatively lower intensity. RESULTS: Through hemi-laminectomy from C3-C4 and facetectomy of the left side of C3-C4, the intradural parts of the multinodular tumor were completely extirpated and extradural parts of the multinodular tumor were enucleated as much as possible. Gross examination of the tumor showed yellowish-white soft contents that were encapsulated and multilobulated. Histologic examination revealed benign schwannoma. After surgery, preoperative neurologic symptoms completely resolved. CONCLUSION: To the best of our knowledge, this is the first reported case of intra-extradural plexiform schwannoma. Careful magnetic resonance imaging might be helpful in suggesting this rare plexiform schwannoma before surgery.
Intra-extradural plexiform schwannoma of the cervical spine. Publishing Authors By Initials
