title: Ancient schwannoma of lumbar spine and review of the literature on paraspinal tumors, the role of preoperative biopsy: a case report.
abstract: BACKGROUND
  Schwannomas are rare encapsulated tumors that derive from the nerve sheath and should be removed due to their infrequent, but existent possibility of malignancy.
  
  
  METHODS
  We report a case of a mass located in the L5 lumbar spine in a 42 year old man, presented with intermittent lumbar pain. Ultrasound, CT and MRI were used to examine the characteristics of the lesion. Fine needle aspiration showed cytologic characteristics of benign schwannoma and final histological diagnosis was ancient schwannoma. An extraperitoneal approach, through a left paramedian incision was used to approach the site of the mass. The lesion originated from the nerve root of the L4-L5 lumbar spinal space and a complete excision was achieved.
  
  
  CONCLUSIONS
  A great variety of tumors should be differentiated when a paraspinal mass is discovered, including neurogenic, neuroendocrine and vascular tumors, as well as malignancies, cystic and inflammatory masses. Fine needle aspiration is a useful and reliable tool in the preoperative evaluation of paraspinal masses. A review of the literature is also presented.
authors.affiliation: Department of Surgery, Nikea General Hospital, 3D Mantouvalos St, Nikea Pireus, 18454, Greece.
authors.forename: Constantine
authors.initials: C
authors.lastname: Antonopoulos
authors.forename: Constantine
authors.initials: C
authors.lastname: Lilimpakis
authors.forename: Maria
authors.initials: M
authors.lastname: Karagianni
authors.forename: Dimitra
authors.initials: D
authors.lastname: Daskalopoulou
authors.forename: Theodoulos
authors.initials: T
authors.lastname: Kyriakou
authors.forename: Constantine
authors.initials: C
authors.lastname: Vagianos