Mobile thoracic schwannoma combined with intraosseous schwannomas A case report

Rationale: Mobile schwannomas have been rarely reported in the lumbar and thoracic spine. These entities are usually intradural extramedullary involving less than 3 vertebrae. Here, we present a rare case of thoracic schwannoma moving over 4 vertebral levels from the primary site combined with intraosseous schwannomas. Patient concerns: A 64-year-old woman presented with back pain for several months. Diagnoses: Preoperative computed tomography (CT) and magnetic resonance imaging (MRI) showed 2 intraosseous tumors at the T7 and T8 levels and an intradural extramedullary tumor at the T5-6 levels. Interventions: The patient underwent a surgical resection of the intraosseous tumors at the T7 and T8 levels, and the tumor at the T5-6 levels was not found. Postoperative MRI showed that the intradural extramedullary tumor had moved to the T3-4 levels. Subsequently, the patient developed gait disturbance and numbness on bilateral lower limbs. During the second operation, we found the tumor at the T1-2 levels. Eventually, the tumor was completely removed. Outcomes: Histopathological examination showed schwannomas. After a 3-month follow-up, the symptoms were significantly relieved, and there was no clinical or radiological recurrence. Lessons: The clinicians should be aware of the coincidence of intraosseous schwannomas and mobile schwannoma. Careful preoperative MRIs are essential for early diagnosis of mobile tumors. Intraoperative localization of the mobile tumor is imperative to prevent unnecessary laminotomy.