TY - JOUR
T1 - Cauda equina malignant peripheral nerve sheath tumor presenting with subarachnoid hemorrhage
T2 - a case report
AU - Aponte-Caballero, Rafael
AU - Sierra-Peña, Julian Alfonso
AU - Abaunza-Camacho, Juan Felipe
AU - Riveros-Castillo, William Mauricio
AU - Saavedra, Javier M
N1 - Copyright © 2024 The Author(s). Published by Elsevier España, S.L.U. All rights reserved.
PY - 2024/10/15
Y1 - 2024/10/15
N2 - Malignant peripheral nerve sheath tumors (MPNST) are uncommon aggressive neoplasms, frequently associated with type I neurofibromatosis. This is the first case of intradural lumbar spine MPNST with intraoperative findings of associated subarachnoid hemorrhage (SAH). A 72-year-old man presented to the emergency department with severe acute low back pain. Neurological examination was unremarkable. Gadolinium-enhanced MRI of the lumbar spine showed an irregularly shaped intradural lesion extending from L3 to L5. The lesion exhibited a medium signal both on T1 and T2-weighted imaging with peripheral enhancement. Through an L3-L5 laminectomy, a diffuse SAH, and a tumor tightly adherent to cauda equina nerve roots were found. Specimen examination revealed a fusocelular tumor with pleomorphic and hyperchromatic nuclei, positive for S100, and SOX10. On an 8-month follow-up, he had no neurological deficit, with a Karnofsky performance score of 90 points. Surgical evidence of SAH in lumbar spine intradural MPNST is a novel finding.
AB - Malignant peripheral nerve sheath tumors (MPNST) are uncommon aggressive neoplasms, frequently associated with type I neurofibromatosis. This is the first case of intradural lumbar spine MPNST with intraoperative findings of associated subarachnoid hemorrhage (SAH). A 72-year-old man presented to the emergency department with severe acute low back pain. Neurological examination was unremarkable. Gadolinium-enhanced MRI of the lumbar spine showed an irregularly shaped intradural lesion extending from L3 to L5. The lesion exhibited a medium signal both on T1 and T2-weighted imaging with peripheral enhancement. Through an L3-L5 laminectomy, a diffuse SAH, and a tumor tightly adherent to cauda equina nerve roots were found. Specimen examination revealed a fusocelular tumor with pleomorphic and hyperchromatic nuclei, positive for S100, and SOX10. On an 8-month follow-up, he had no neurological deficit, with a Karnofsky performance score of 90 points. Surgical evidence of SAH in lumbar spine intradural MPNST is a novel finding.
U2 - 10.1016/j.neucie.2024.10.001
DO - 10.1016/j.neucie.2024.10.001
M3 - Artículo
C2 - 39414230
SN - 2529-8496
JO - Neurocirugia (English Edition)
JF - Neurocirugia (English Edition)
ER -