title: Giant invasive spinal schwannoma in children: a case report and review of the literature.
abstract: BACKGROUND
  Giant invasive spinal schwannoma is defined as a tumor that extends over two or more vertebral levels, erodes vertebral bodies, and extends into the extraspinal space disrupting myofascial planes. Because of its rarity, there have been few published reports describing clinical features and surgical outcomes, especially in the pediatric patient population.
  
  
  METHODS
  We analyzed the medical record, pathologic findings, and radiographic studies of a 14-year-old Hispanic boy who presented to Texas Children's Hospital with a three-month history of progressive spastic paraparesis. Preoperative computed tomography and magnetic resonance imaging reports showed a large mass lesion centered at the left T7-8 neural foramen with intra- and extraspinal extension, resulting in severe spinal cord compression and vertebral body erosion, and protrusion into the retropleural space and descending aorta. Our patient underwent a single-stage posterior approach for complete resection of the tumor with reconstruction and stabilization of the vertebral column. The pathological examination was consistent with schwannoma. At the six-month follow-up, our patient had resolution of preoperative symptoms and remains neurologically intact without any radiographic evidence of recurrent tumor.
  
  
  CONCLUSIONS
  To the best of our knowledge, our case represents the fourth child with giant invasive spinal schwannoma reported in the literature. We describe our case and review the literature to discuss the aggregate clinical features, surgical strategies, and operative outcomes for giant invasive spinal schwannoma in the pediatric age group.
authors.forename: Sudhakar
authors.initials: S
authors.lastname: Vadivelu
authors.forename: Prashant
authors.initials: P
authors.lastname: Prasad
authors.forename: Adekunle M
authors.initials: AM
authors.lastname: Adesina
authors.forename: Eugene
authors.initials: E
authors.lastname: Kim
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Luerssen
authors.affiliation: Neuro-spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, 6621 Fannin Street, Houston, TX 77030, USA. ahjea@texaschildrens.org.
authors.forename: Andrew
authors.initials: A
authors.lastname: Jea