Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
NOVEMBER 2012
Next Case of the Month coming December 4...
Benign Hemorrhagic Cystic Schwannoma
- Spinal schwannomas (25%) are benign, slow-growing, well encapsulated tumors arising from the Schwann cells.
- Cystic degeneration and repeated hemorrhages (10%) can sometimes occur in schwannomas. There are two types of tissues in Schwannomas, viz. Antoni A and Antoni B. Layering with fluid-fluid levels is caused by hemorrhages. Usually, Antoni B portion undergoes cystic and hemorrhagic degeneration.
- Although rare, they can be expansile and cause osteolytic destruction of the vertebra.
- Key Diagnostic Features: A large multiloculated cystic mass with fluid-fluid levels due to hemorrhage is seen. Expansion of the neural foramen is common. No tumor bone matrix/bony septae are seen to suggest primary bone tumor.
- DDx: aneurysmal bone cyst (ABC); giant cell tumor; secondary ABC in osteoblastoma; meningioma; metastasis; neurofibroma
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