Korean J Spine.  2017 Sep;14(3):89-92. 10.14245/kjs.2017.14.3.89.

Single Stage Posterior Approach for Total Resection of Presacral Giant Schwannoma: A Technical Case Report

• Lee BH
• Hyun SJ
• Park JH
• Kim KJ

• KMID: 2396045
• DOI: http://doi.org/10.14245/kjs.2017.14.3.89

Abstract

The neurogenic tumor of frequent occurrence in the presacral area is a schwannoma. Giant presacral schwannoma has a risk for anterior surgical approach because of its massive size and proximity to abundant vascularity of presacral region. We report a single stage posterior approach for total resection of a giant presacral schwannoma. A 40-year-old female patient experienced left buttock pain and tingling sensation at left S1 dermatome. Magnetic resonance imaging showed that the presacral huge mass at S1-3 level with osseous extension and structural remodeling in left sacral ala. The presacral mass was ranging in maximum diameter from 8.0 to 8.6 cm. S2 foramen laminectomy was performed to expose the mass. The tumor capsule and the root were carefully dissected away. The tumor was removed while preserving the capsule by dissecting the plane between the inner wall of the capsule and the tumor. The single stage posterior approach for presacral giant schwannoma is feasible, and it can be a good surgical alternative to prevent pelvic organ or vascular damage and anterior approach related dystocia and infertility.

Keyword

Presacral giant schwannoma; Excision; Neurogenic tumor; Posterior approach

MeSH Terms

Adult
Buttocks
Dystocia
Female
Humans
Infertility
Laminectomy
Magnetic Resonance Imaging
Neurilemmoma*
Pregnancy
Sensation