Sacral intraosseous schwannoma in an adolescent patient: A case report

Schwannomas are benign peripheral nerve sheath tumors arising from Schwann cells and, as a result, can occur anywhere in the body. Intraosseous schwannomas are a rare subset of these tumors that are usually found in the medullary cavities of bones. According to the available literature, the sacrum is a common site of involvement within the spine. Affected patients are typically adults older than 20 years of age with no male or female predilection. We present a 17-year-old female athlete with low back pain and radiculopathy. Initial lumbar spine radiographs and magnetic resonance imaging were reported to be negative. Months later, dedicated imaging studies were performed after an abnormality of the sacrum was suspected during medical evaluation for return to sports. A sacral mass was confirmed. Initial and repeat image-guided biopsies confirmed a benign schwannoma. Detection and diagnosis of sacral intraosseous schwannomas present a challenge in the pediatric population given their rare occurrence. Although their imaging features have been described, intraosseous schwannomas are infrequently included in the list of differential diagnoses. Their nonaggressive imaging features should allow interpreting radiologists to narrow the potential diagnoses, thereby helping clinicians arrive at the correct diagnosis more efficiently.