[Spinal Intradural Schwannoma with Torsion: A Case Report]

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Schwannomas are typically benign peripheral nerve sheath tumors.
• Intradural spinal schwannomas are uncommon, and torsion is an exceptionally rare presentation.
• Lumbar schwannomas can cause symptoms due to nerve root compression.

Observation:

• A 63-year-old male presented with right sacral pain radiating to the lower extremity.
• Magnetic resonance imaging (MRI) revealed an intradural lumbar mass with minimal enhancement.
• The tumor's position appeared variable on serial MRI and CT-myelography examinations.

Findings:

• Surgical resection confirmed an intradural lumbar schwannoma.
• The cauda equina was found to be severely twisted, tethered to the tumor.
• The tumor's dynamic location and minimal enhancement posed diagnostic challenges.

Implications:

• This case highlights the rare occurrence of intradural schwannoma with torsion.
• The findings emphasize the importance of considering unusual presentations in spinal tumor diagnosis.
• Understanding the relationship between tumor mobility and neurological compromise is crucial for surgical planning.