Giant cystic intradural schwannoma in the lumbosacral region: a case report

Jaiswal A, Shetty AP, Rajasekaran S
Department of Orthopaedics and Spine Surgery, Ganga Hospital, Coimbatore, India

We report a case of a giant cystic intradural schwannoma of the lumbosacral region in a 30- year-old man who presented with a 2-year history of non-specific lower back pain. Lateral radiographs demonstrated scalloping of the posterior wall of L5 and the upper sacrum. Magnetic resonance imaging revealed a 12x2.3-cm intradural multi-septated cystic lesion extending from L3 to S2 with predominant hypointense signal on T1-weighted images and a mixed signal on T2-weighted images. There was heterogeneous rim enhancement of the retrosacral portion of lesions following the administration of gadolinium contrast. The tumour was completely excised. Histological investigation confirmed the diagnosis of cystic schwannoma with alternating hypercellular (Antoni A) and hypocellular (Antoni B) areas in a fibrillar background. The patient had complete relief of symptoms and remained asymptomatic after 2 years of follow-up.