Giant sacral schwannoma A case report and review of the literature


Published online: Oct 27 2009

Cagatay Ozturk, Cuneyt Mirzanli, Omer Karatoprak, Mehmet Tezer, Mehmet Aydogan, Azmi Hamzaoglu

From the Istanbul Spine Center, Florence Nightingale Hospital, Istanbul, Turkey

Abstract

Intraspinal schwannomas localized in the sacrum are relatively infrequent, accounting for 1-5% of all spinal axis schwannomas. They frequently grow to considerable size before detection ; hence, the term giant sacral schwannoma. Sacral schwannomas arise from the sacral nerve roots. The diagnosis of schwannomas in the spinal canal is difficult because of their slow growth, often resulting in extensive bony destruction. This case report documents the management of a 48-year-old male with a giant sacral schwannoma. We performed a two-stage surgery with intralesional tumour resection. The patient is now free of any complaint, complications and there is no recurrence two years after resection of the schwannoma. Intralesional excision of a sacral schwannoma is a less invasive procedure than total or partial sacrectomy. Using a combined anterior and posterior approach, satisfactory tumour excision and stabilization can be achieved, while avoiding the high morbidity related with total sacrectomy.