Recurrent giant invasive thoracolumbar schwannoma

Giant invasive spinal schwannoma is a new term proposed by Sridhar in 2001 for a particularly aggressive type of benign spinal schwannoma. Only a few cases have been published, the majority of these located in the lumbosacral spine, two in the thoracic and only one in the cervical spine. A rare case of such a tumor is presented. The tumor predominantly occupied level L1 and partially levels T12 and L2, and recurred 13 years after the first seemingly radical excision of a benign melanotic schwannoma. The highly vascularized tumor was radically excised using the dorsal approach, and a Sokon transpeduncular fixation was performed. Carter's lateral thoraco-abdominal access allowed the retroperitoneal and intravertebral expansions of the tumor to be removed and L1 corpectomy to be accomplished. Ventral vertebral stabilization was achieved with a titanium cage. After the operation, the pain in the patient's left leg subsided. Three years after the management, he is still pain-free, able to walk freely and to resume his usual daily activities.