Resection of a Cauda Equina Schwannoma Using a Minimally Invasive Approach
Keywords:
schwannomas, neuromas, nerve sheath tumorsAbstract
Introduction: Schwannoma is a slow-growing benign tumor. They are most common in the fourth to sixth decades of life, very rare in children and young adults. Pain and paresthesia are the main clinical symptoms. Motor and sphincter alterations are other clinical presentations, but less frequent. In general, the definitive approach is total surgical excision, mainly in symptomatic patients or on those with accelerated growth pattern tumors or at risk of a new neurological deficit.
Objective: To describe a case of cauda equina schwannoma treated surgically with endoscopic support.
Clinical case report: The case of a 23-year-old male patient is reported, who in April 2021 began having voiding difficulties such as urinary incontinence. Four months after the onset of the initial symptoms, he began to have difficulty walking due to decreased strength of his right lower limb. In October of the same year, he began with dysesthesia in his right lower limb with no a specific root path. The neurological examination revealed decreased muscle strength, hypotonia, and patellar and Achilles hyporeflexia in the right lower limb.
Conclusions: Cauda equina schwannomas are rare lesions in early life. These cases may present with clinical manifestations of sphincter and motor neurological deficits. Surgical resection of the tumor is the first treatment option and its prognosis improves considerably if using minimally invasive surgical techniques.Downloads
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