caa a22 4500 606215026 CHVBK 20210128101057.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s00701-014-2320-5 doi (NATIONALLICENCE)springer-10.1007/s00701-014-2320-5 Treatment of large thoracic and lumbar paraspinal schwannoma [Elektronische Daten] [Theresa Krätzig, Marc Dreimann, Mark Klingenhöfer, Frank Floeth, Kara Krajewski, Sven Eicker] Background: Paraspinal neurogenic tumors usually expand into the mediastinum and retroperitoneum and can reach a considerable size before they become symptomatic. Such large tumors are rare. We describe 14 cases of large schwannomas (>2.5cm ø) with mild and late onset of symptoms, which were treated with total surgical resection through a single-approach surgery. Methods: In 2013 14 patients with paraspinal large schwannomas were treated in our institutions. Data were analyzed retrospectively. Magnetic resonance imaging (MRI) showed lesions suspicious for a paraspinal schwannoma with partial intraforaminal growth. In case of ambiguity regarding tumor dignity, a needle biopsy was performed before final treatment. Three different approaches and their indications were discussed. Results: Fourteen patients (7 female and 7 male, ages 18-58years, mean: 39.8years) requiring surgical exploration because of a thoracic (6) or lumbar/lumbosacral (8) lesion were treated in our institutions. Two patients received CT-guided needle biopsy preoperatively. Complete resection of the schwannoma was possible through a mini-thoracotomy in 1 case (7%), a retroperitoneal approach in 2 cases (14%), and dorsal interlaminar and intercostal fenestration in 11 cases (79%). Histological examination revealed the diagnosis of schwannoma (WHO grade I) in all cases except one with neurofibroma (WHO grade I). There were no major complications in any case. Conclusion: Large benign schwannomas are rare. They need a tailored treatment, which in most cases works through one surgical approach. Usually it is possible to perform a complete resection with a good postoperative prognosis. Springer-Verlag Wien, 2015 Large schwannoma nationallicence Paraspinal nationallicence Retroperitoneum nationallicence Thoracic nationallicence Schwannoma nationallicence Krätzig Theresa Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Dreimann Marc Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg, Hamburg, Germany aut Klingenhöfer Mark Spine Center, Hospital Dresden-Friedrichstadt, Dresden, Germany aut Floeth Frank Department of the Spine and Pain, St Vinzenz Hospital, Düsseldorf, Germany aut Krajewski Kara Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Eicker Sven Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 531-538 0001-6268 157:3<531 2015 157 701 https://doi.org/10.1007/s00701-014-2320-5 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-014-2320-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Krätzig Theresa Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Dreimann Marc Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg, Hamburg, Germany aut NATIONALLICENCE 700 1- Klingenhöfer Mark Spine Center, Hospital Dresden-Friedrichstadt, Dresden, Germany aut NATIONALLICENCE 700 1- Floeth Frank Department of the Spine and Pain, St Vinzenz Hospital, Düsseldorf, Germany aut NATIONALLICENCE 700 1- Krajewski Kara Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Eicker Sven Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/3(2015-03-01), 531-538 0001-6268 157:3<531 2015 157 701