Epidemiology
MS occurs at a younger age than conventional schwannoma, without gender predilection, and it is more common in patients aged 30 to 40 years 67. [PMID:33663098]
MS affects patients aged 10 to 92 years, but the peak age at onset is 30 to 40 years, and no sex predilection exists [PMID:32809891].
Clinical Presentation
A 29-year-old woman presented with a 1-day history of backache, mild weakness, and hypermyotonia in the right leg [PMID:33663098]
The patient presented with an 8-month history of neck pain, 6-month history of numbness and weakness in the upper extremities, and diminished skin sensation [PMID:32809891].
The case report describes a 44-year-old patient with a mediastinal tumour spreading intraspinally, forming a characteristic 'dumbbell' shape [PMID:11794055].
Diagnosis
FDG PET/CT has a unique value in detecting malignant MS lesions, highlighting its utility beyond MRI in identifying aggressive features [PMID:33663098]
MRI of the cervical spine revealed hypointense masses in the spinal canal at the C2 to C4 vertebral bodies on T1- and T2-weighted imaging, indicating the tumor's location in the epidural space [PMID:32809891].
Management
The authors emphasize the necessity to remove the tumour in toto, suggesting a one-stage operation in collaboration with a neurosurgeon for a mediastinal melanotic schwannoma spreading intraspinally [PMID:11794055].
Prognosis & Follow-up
The patient in this case had a postoperative course without complications and was discharged in good condition on the 8th postoperative day [PMID:11794055].
References
1 Shen XZ, Wang W, Luo ZY. 18F-FDG PET/CT imaging for aggressive melanotic schwannoma of the L3 spinal root: A case report. Medicine 2021. link 2 Hou Z, Shi T, Li G, Tian L, Li X, Liu X. Extramedullary melanotic schwannoma recurrence in the cervical vertebral arch: a case report and review of the literature. The Journal of international medical research 2020. link 3 Belák J, Vajó J, Böör A, Janík M, Sauka C, Lukác I et al.. [A "dumbell" tumor of the mediastinum--case report]. Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti 2001. link