Clinical outcomes following resection of giant spinal schwannomas: A case series of 32 patients

Madeleine Sowash, Ori Barzilai, Sweena Kahn, Lily McLaughlin, Patrick Boland, Mark H. Bilsky, Ilya Laufer*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: The objective of this study was to review clinical outcomes following resection of giant spinal schwannomas. METHODS: The authors conducted a retrospective review of a case series of patients with giant spinal schwannomas at a tertiary cancer hospital. RESULTS: Thirty-two patients with giant spinal schwannomas underwent surgery between September 1998 and May 2013. Tumor size ranged from 2.5 cm to 14.6 cm with a median size of 5.8 cm. There were 9 females (28.1%) and 23 males (71.9%), and the median age was 47 years (range 23-83 years). The median follow-up duration was 36.0 months (range 12.2-132.4 months). Three patients (9.4%) experienced recurrence and required further treatment. All recurrences developed following subtotal resection (STR) of cellular or melanotic schwannoma. There were 3 melanotic (9.4%) and 6 cellular (18.8%) schwannomas included in this study. Among these histological variants, a 33.3% recurrence rate was noted. In 1 case of melanotic schwannoma, malignant transformation occurred. No recurrence occurred following gross-total resection (GTR) or when a fibrous capsule remained due to its adherence to functional nerve roots. CONCLUSIONS: Resection is the treatment of choice for symptomatic or growing giant schwannomas, frequently requiring anterior or combined approaches, with the goals of symptom relief and prevention of recurrence. In this series, tumors that underwent GTR, or where only capsule remained, did not recur. Only melanotic and cellular schwannomas that underwent STR recurred.

Original languageEnglish
Pages (from-to)494-500
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume26
Issue number4
DOIs
StatePublished - Apr 2017
Externally publishedYes

Keywords

  • Cellular schwannoma
  • Giant schwannoma
  • Melanotic schwannoma
  • Nerve sheath tumor
  • Oncology
  • Spinal tumor

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