Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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September 14, 2009
Multiple Nonsyndromic Schwannomas
- Schwannomas are the most common intradural extramedullary tumors; meningioma is 2nd. Most schwannomas are intradural/extramedullary (70-75%), 15% are extra/intradural (dumbell-shaped), 15% are completely extradural and, rarely, they are intramedullary. They are more frequent in cervical and thoracic regions.
- Hemorrhage and cystic degeneration are more common in schwannoma than neurofibroma; calcification is more common in meningioma.
- On MRI, 75% are T2 hyperintense, 'target sign' is rare (high signal rim, low intensity center). They show intense enhancement after contrast, homogeneous or heterogeneous (peripheral).
- Nonsyndromic lesions are usually solitary. Multiple can occur in patients with or without neurofibromatosis 2, schwanomatosis (no vestibular tumors) and Carney syndrome.
- Schwannomas may be: typical, ancient, melanocytic, sarcomatous or Triton tumors.
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