Cervical dumbbell-type tumor spontaneously shrinking following an ischemic stroke

Area of Science:

• Neurosurgery
• Radiology
• Oncology

Background:

• Cervical dumbbell-type tumors are often incidentally diagnosed and asymptomatic.
• The natural history and chronological changes in size of these tumors remain poorly understood.
• Spinal schwannomas can present as dumbbell-type lesions, extending through neural foramina.

Observation:

• A 57-year-old male patient was monitored for a 7-year period for an asymptomatic cervical dumbbell tumor.
• Magnetic resonance (MR) imaging revealed the tumor, suspected to be a schwannoma, compressing the spinal cord and right vertebral artery.
• The patient suffered a cerebral infarction due to right vertebral artery atherosclerosis, with imaging confirming tumor compression of the artery.

Findings:

• Following the cerebral infarction, the cervical dumbbell tumor exhibited spontaneous shrinkage over 4 years on serial MR imaging.
• The tumor's regression led to a significant relief of both spinal cord and right vertebral artery compression.
• This case documents the first reported instance of spontaneous tumor regression following a cerebrovascular event.

Implications:

• This case suggests a potential link between cerebrovascular events and the regression of certain spinal tumors.
• Further research is warranted to explore the mechanisms underlying spontaneous tumor shrinkage.
• Understanding such phenomena could offer novel therapeutic insights for managing spinal tumors.