title: Giant schwannoma with extensive scalloping of the lumbar vertebral body treated with one-stage posterior surgery: a case report.
abstract: BACKGROUND
  Schwannoma is a relatively common benign spinal cord and/or cauda equina tumor; however, giant cauda equina schwannoma with extensive scalloping of the lumbar vertebral body is a rare pathology, and the treatment strategy, including the use of surgical procedures, is controversial. In this report, we present a rare case of a giant lumbar schwannoma of the cauda equina with extremely large scalloping of the vertebral body, and we discuss the surgical strategy we used to treat this pathology.
  
  
  METHODS
  A 42-year-old Japanese man presented to our department with complaints of a gait disturbance and muscle weakness in the left lower limb. His muscle strength in the proximal part of the left lower limb was grade 2 or 3/5, and he exhibited a mild urinary disturbance on the first visit. X-ray and computed tomography myelography of the lumbar spine showed an extremely large erosive lesion at the L3 vertebral body. Magnetic resonance imaging of the lumbar spine showed a large soft-tissue mass in the spinal canal at L2-L3 and the vertebral body at L3. A one-stage complete tumor resection and instrumented circumferential fusion were performed via a posterior approach, and a good outcome was achieved after the surgery.
  
  
  CONCLUSIONS
  We performed one-stage posterior surgery in a patient with a giant cauda equina schwannoma with extensive scalloping of the vertebral body, and a good post-operative outcome was achieved.
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa, Maebashi, Gunma 371-8511, Japan. yoiizuka@gunma-u.ac.jp.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Iizuka
authors.forename: Haku
authors.initials: H
authors.lastname: Iizuka
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Kobayashi
authors.forename: Tokue
authors.initials: T
authors.lastname: Mieda
authors.forename: Kenji
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000328:Adult; D002420:Cauda Equina / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000175:diagnosis* / Q000601:surgery*; D013123:Spinal Fusion; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D014057:Tomography, X-Ray Computed