Pure ventral midline long segment schwannoma of the cervicodorsal spine: a case report

Spinal intradural extramedullary schwannomas commonly occur posterolateral or anterolateral to the spinal cord. A case of a pure midline ventrally situated cervicodorsal extramedullary schwannoma in a 33-year-old female patient with subacute cord compression and sphincteric involvement is presented. Spinal MR imaging showed a C2-D3 midline ventrally situated extramedullary tumor with severe spinal cord compression. It was resected through a posterolateral approach. Histology was consistent with a schwannoma. There was a gradual improvement in left-sided spasticity but the patient had mild diaphragmatic paresis. MR imaging showed no evidence of the tumor at followup after 6 months. The radiological features, pathogenesis and surgical strategies in management of these difficult tumors are discussed and the relevant literature is briefly reviewed.