Factors predicting recurrence in benign spinal nerve sheath tumors: A retrospective study of 457 patients from a single institution

BACKGROUND

Benign Nerve sheath tumors (NST) comprise almost one-third of primary spinal tumours. The majority are sporadic. They have low rates of recurrence but an occasional recurrence may need re-surgery. The present study was designed to identify the variables that can predict the risk of their recurrence.

METHODS

A retrospective chart review was done including all the histologically proven benign spinal NSTs operated between 2001 and 2019 in our institute. Demographic, operative and postoperative follow-up data were recorded. Recurrence was defined as local reappearance after definite surgical excision or symptomatic increase in size of a residual tumour on follow-up imaging studies. Statistical analysis was done to determine the significant variables associated with local recurrence.

RESULTS

457 patients with a median age of 38 years operated for 459 NSTs qualified for the study. The most frequent location of occurrence of tumours was found to be Low Cervical level (C3-C7 levels). Majority of Schwannoma were located intradurally while Neurofibroma were dumb-bell shaped and extradural. Most of the tumours had solid consistency. Post operatively, 7.7% patients developed complications. 7.8% tumours developed local recurrence after median period of 12 months. The patients developing recurrence were younger compared to nonrecurring tumors. On univariate analysis, male gender, Low cervical and Cervicothoracic junction location were associated with higher recurrence. On multivariate analysis, location at Cervicothoracic junction reached significance.

CONCLUSION

Overall recurrence risk among all NST was 7.8% with a median progression free survival of 36 months. The location of tumour at cervicothoracic location was the significant risk factors for recurrence of tumour in our study.

Mobile Schwannomas of lumbar spine: A diagnostic dilemma

Mobile Schwannoma is a very rare entity and is reported sparsely in literature, with most of them occurring in lumbar spine region. We present a case of seventy-year-old male patient who had pain in lower back radiating to ipsilateral thigh. A diagnosis of migratory tumour was made based on findings of plain and contrast MRI preoperatively. We did a two level laminectomy and tumour excision. In this report, we intend to discuss various likely causes of tumour migration and various diagnostic methods to tackle this surgical dilemma, we have also attempted to review the sparse literature available till date on migratory lumber schwannoma.