ArticleSurgical neurology international2026
Spinal schwannoma with broad pial adhesion: A case report.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Typical spinal schwannomas are well-encapsulated intradural extramedullary tumors arising from sensory nerve roots. Schwannomas adherent to the spinal cord are rare and include both intramedullary (subpial) and combined intra- and extramedullary lesions. Here, a 60-year-old male initially presented with a combined intra/extramedullary schwannoma with dense adhesions to the spinal cord; at surgery, this proved to be a peripheral schwannoma with broad pial adhesions. Case Description: A 60-year-old male presented with severe paraparesis attributed to a dorsal thoracic T11 tumor. Chronic hemodialysis precluded performing a contrast magnetic resonance. Intraoperative ultrasonography showed a well-defined, multi-cystic, and dorsal lesion without intramedullary extension. After dural opening, the tumor was tightly adherent to the dorsal spinal cord/pia. A staged internal decompression improved tumor mobility, allowing the tumor to be progressively dissected away from its broad-based pial adhesion/vasculature. Finally, a clean cleavage plane between the tumor capsule and spinal cord confirmed that the tumor was an extramedullary, broad-based pial schwannoma that was totally resected without neurological sequelae. Conclusion: Peripheral spinal schwannomas may occasionally exhibit broad-based pial adhesions that mimic intramedullary (subpial) or combined intra/extramedullary lesions. Proceeding with a step-wise resection often reveals an increasingly clean cleavage plane facilitating gross total tumor resection.
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