Nerve.  2023 Apr;9(1):51-55. 10.21129/nerve.2022.00241.

Spontaneous Shrinkage of a Dumbbell-Shaped Schwannoma in the Cervical Spine: A Case Report

• Lee SY
• Kim KH
• Park JY
• Chin DK
• Kim KS
• Cho YE
• Jang HJ

• KMID: 2543259
• DOI: http://doi.org/10.21129/nerve.2022.00241

Abstract

Cervical dumbbell-shaped schwannomas are uncommon and challenging; clinicians often face the choice between performing incomplete tumor resection and sacrificing nerve roots. Aggressive and total resection is the treatment of choice for this tumor, although surgical resection in asymptomatic patients remains a matter of debate. We present a case report of spontaneous shrinkage of a dumbbell-shaped schwannoma of the cervical spine. A 68-year-old female patient first presented in 2013 with a progressive history of pain in the lower back and both buttocks over the previous 10 years. A dumbbell-shaped cervical spine tumor that had a 30-mm maximum diameter with a foraminal obstruction was identified, along with multiple tiny intradural extramedullary tumors in the lumbar spine. The cervical tumor gradually decreased in size during annual follow-up visits through 2015. Magnetic resonance imaging conducted in November 2017 revealed that this dumbbell-shaped tumor had shrunk significantly, leaving only the paravertebral section with a maximal diameter of 14 mm. This case demonstrated a schwannoma that naturally decreased in size with no treatment. Clinicians should consider the possibility of a spontaneous reduction in schwannoma size when making treatment decisions in asymptomatic patients, in whom avoiding unnecessary surgery may prevent nerve root damage.

Keyword

Dumbbell-shaped tumors; Schwannoma; Spontaneous shrinkage; Spinal neurogenic tumor