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Case Reports
. 2016 Apr 18:14:113.
doi: 10.1186/s12957-016-0864-y.

Coexistence of intervertebral disc herniation with intradural schwannoma in a lumbar segment: a case report

Jianjiang Pan  1 , Yue Wang  2 , Yazeng Huang  3
Affiliations
Case Reports

Coexistence of intervertebral disc herniation with intradural schwannoma in a lumbar segment: a case report

Jianjiang Pan et al. World J Surg Oncol. .

Abstract

Background: Lumbar intervertebral disc herniation and spinal tumor are major pathologies that may cause back pain and radiculopathy. Neurological symptoms resulting from disc herniation and intradural spinal tumor together, however, are very rare.

Case presentation: We report a case of lumbar disc herniation which coexists with intradural schwannoma at the same spinal level in a 67-year-old man. The patient presented with persistent low back pain, sciatica, and weakness of the lower limbs. Contrast lumbar spine magnetic resonance (MR) imaging clearly delineated an intradural lesion and an extradural herniated disc at L3/4 level. Using a single posterior approach, both pathologies were addressed. Pathological studies confirmed the intradural lesion was schwannoma.

Conclusion: The case report highlights a rare concomitance of two symptomatic pathologies in a lumbar spine, which deserves clinical attention. Complete history, careful physical examination, and investigative measures, such as contrast MR imaging, are helpful to establish throughout diagnoses.

Keywords: Intraspinal tumor; Lumbar disc herniation; Schwannoma.

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Figures

Fig. 1
Fig. 1
T2-weighted sagittal image (a) revealed L3/4 disc herniation which compressed the dural sac from the right side. Two slices away, there was a hyperintense intradural mass at the same level (b). T1-weighted sagittal image (c) demonstrated a hypointense mass behind the L3/4 intervertebral disc
Fig. 2
Fig. 2
Gadolinium contrast MR images (a coronal image, b sagittal image) demonstrated a partially enhanced intradural mass at the left side of the L3/4 spinal canal. Axial image (c) showed an intradural mass of heterogeneous signal at the left and a herniated disc at the right extradural space
See this image and copyright information in PMC

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