[Giant, invasive sacral schwannoma extending to the 4th lumbar spine]

In this report, we describe a case with giant sacral schwannoma, which invasively extended to the 4th lumbar spine and to the surrounding sacral and iliac bone. A 26-year-old female was admitted to our hospital because of numbness and transient weakness of the right leg, and dysuria. Radiological examinations revealed that a giant sacral tumor, associated with multiple cystic formations, had invasively extended to the 4th lumbar spine, sacrum, and iliac bone. She underwent partial removal of the tumor, followed by irradiation. Pathological diagnosis was schwannoma. Subsequently, she underwent a second operation because of tumor regrowth 15 months later, and the tumor was totally removed. Numbness of the right leg resolved after surgery. No tumor recurrence has been noted during 5-year follow-up period. Previously, only 5 cases have been reported of invasive sacral schwannoma extending to the lumbar spine. Our experience in this rare case strongly suggests that aggressive resection should be aimed to improve long-term outcome.