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[Dumbbell neurogenic tumors. 5 cases (4 thoracic, 1 lumbar)]
Abstract:
Benign in more than 90% cases, dumbbell neurogenic tumors are rare. It was 3 thoracic schwannome and 1 thoracic ganglioneuroma and 1 lumbar schwannoma are reported. In 2 cases complete removal was performed by thoracotomy, in another case thoracic removal was incomplete with leateag of spinal fluid, laminectomy was necessary 3 months later and in a third case laminectomy was performed first because of paraplagia and thoracotomy one month later. In lumbar case a two ways procedure in 3 weetes space permitted complete removal, a monoparesia and sphincters troubles, regressive spontaneously in 5 months, complicated first performed laminectomy. Schwannome and benign neurofibroma are the most frequent tumors. Latero vertebral situation in chest radio or in abdominal ultrasonography must induce neurogenic tumors diagnosis. Myelography or tomodensitometry confirms intraspinal extension when osseous signs are present on vertebral radiographies. In thoracic localization a one stage combined resection gives the lowest morbidity. In lumbo-sacral localization tumoral large size requires a combined approach, which can be performed in a single stage. Recklinghausen's association in neurofibroma (4 to 16%) exposes to malign evolution risk (12 to 13%).