Spinal intraosseous schwannoma without spinal canal and neuroforamina involvement: A case report

Figure 1 Imaging findings before treatment. A: Cervical X-ray showed loss of height of the seventh cervical (C7) vertebral body; B: Sagittal T2-weighted magnetic resonance imaging of the cervical spine showing a hyperintense prevertebral mass; C: Axial magnetic resonance imaging showed a well-demarcated lesion seemingly originating in corpus C7 without spinal canal and neuroforamina involvement; D: Axial computed tomography (CT) shows lytic changes in the anterior cortical margin of C7 body. Posterior cortical margin is intact; E: CT scanning exhibited a bony defect of the C7 body; F: Three-dimensional CT reconstruction shows a circular defect in the anterior edge of the C7 vertebra.

Figure 2 Histological examination of the lesion (hematoxylin and eosin; × 200). A: Histology revealed hypercellular (Antoni A) and hypocellular (Antoni B) areas, indicating a typical schwannoma; B: Tumor cells constitute the Verocay; C: Immunohistochemical study for S100 protein is diffusely positive; D: Immunohistochemistry showed positive glial fibrillary acidic protein.

Figure 3 Imaging findings after treatment. A-C: The axial computed tomography (CT) images (A), sagittal CT images (B) and the Three-dimensional CT reconstruction (C) of the cervical vertebra after the operation showed a good position for bone grafting; D: The last follow-up cervical X-ray showed no radiological recurrence.

Figure 4 Modified classification of spinal intraosseous schwannomas. Type VI: Tumors in entirely intravertebral location without intraspinal portion; Type VII: Intraspinal tumor with erosion into vertebral bodies (invasive tumor) and extension into nerve root foramen;Type VIII:Tumors including intraosseous tumors with exophytic component without intraspinal or neural foraminal extension.