Intramedullary schwannoma with calcification of the epiconus

Abstract

Background context: There have been few reports on intramedullary ancient schwannoma. Schwann cells are generally present in the nerve root, not in the spinal cord. Thus, intramedullary schwannomas are rare, and in most cases there is cyst formation without calcification.

Purpose: To report a patient with intramedullary ancient schwannoma at the epiconus together with a review of the previously published cases.

Study design: Case report.

Patient: A 78-year-old woman.

Methods: Retrospective case review.

Description of the case: A 78-year-old woman had presented with severe weakness of the lower extremities, increased patellar reflex, and sensory disturbance of the entire lower extremities. Magnetic resonance imaging showed a tumorous mass in the intramedullary region of epiconus at T11-L1, and computed tomography revealed calcification in the tumor. She underwent total resection of the tumor. Histopathological findings were consistent with the diagnosis of ancient schwannoma. After the operation, although lower extremities weakness and sensory disturbance deteriorated transiently, lower leg pain disappeared. At the final follow-up of 10 months after the operation, lower leg pain did not relapse.

Conclusion: We reported a rare case presenting epiconus syndrome due to intramedullary ancient schwannoma, which should be considered for the differential diagnosis of a tumor that shows calcification.