Giant retroperitoneal lumbar Schwannoma: a case report and review of literature

Schwannomas are benign peripheral nerve sheath tumors arising from Schwann cells. Retroperitoneal localization for schwannomas is extremely rare [%3]. The primary surgical approach for such tumors is total resection. This study aimed to report the case of a schwannoma with giant, retroperitoneal extension originating from the L3 nerve root. A 43-year-old female patient was admitted to the department with a cellulosic schwannoma pathology after excisional biopsy at another center. The patient's neurological examination was normal. The lumbar-abdominal contrast-enhanced magnetic resonance imaging [MRI] of the patient revealed a mass lesion in the vertebral compartment 2 × 3 × 3 cm3 and psoas component 8 × 4 × 3 cm3 in size, extending from the right L3 nerve root into the right psoas muscle. The patient was operated postoperatively in the first stage and then using the anterior approach with intraoperative neuromonitoring. Postoperative contrast-enhanced MRI showed no enhancing tumoral lesions. The pathology result was compatible with schwannoma World Health Organization Grade 1. Two-stage surgical procedure in such cases should be preferred to prove the adequacy of the surgical field and avoid the complications that may occur in neighboring anatomical structures during resection of circumferentially circumscribed tumors. Urgent surgical intervention is needed for retroperitoneal lumbar schwannomas. Moreover, elective surgery planning is necessary, and preoperative evaluations should be performed

Occipital aneurysmal bone cysts in an adult patient: a rare case and review of literature

This study aimed to report a rare case of occipital aneurysmal bone cysts [ABCs] in an adult patient. ABCs account for 1% of primary bone tumors. They are usually seen in pediatric age and rare in adults. They are benign fibro-osseous lesions, but they also tend to double in size rapidly and destruct the morphology of the bone. They have a tendency to extend to the long bones and vertebral column. The calvarial ABCs are 3%-6% of ABC. They usually affect the frontal and temporal bones of the skull, and cranial nerve findings are frequently seen. In the adulthood, occipital ABCs are extremely rare. Sixteen cases of occipital ABC, average age 15 years, have been reported in the literature. A 50-year-old female patient was admitted to the clinic with the history of an occipital mass lesion, which had been growing for 6 months. Magnetic resonance imaging and computed tomography of the cranium revealed an irregular-shaped destructive lesion of 55 × 18 × 28 mm3 in the diploe part of the occipital bone. The mass with an approximately 6 cm radius, and 1 cm normal bone edge was completely excised. Because of total resection, no adjuvant therapy was performed. Neither recurrence nor residual lesion was observed in the postoperative 24 months

Late Results of Anterior Cervical Discectomy and Fusion with Interbody Cages

STUDY DESIGN: Retrospective analysis. PURPOSE: To evaluate the effectiveness of anterior cervical discectomy with fusion for degenerative cervical disc disease. OVERVIEW OF LITERATURE: Anterior spinal surgery originated in the mid-1950s and graft for fusion was also employed. Currently anterior cervical microdiscectomy and fusion with an intervertebral cage is a widely accepted procedure for treatment of cervical disc hernia. Artificial grafts and cages for fusion are preferred because of their lower morbidity, reduced operating time and acceptable fusion rate. METHODS: The study involved retrospective analysis and investigation of long-term results for 41 consecutive patients who had undergone anterior cervical discectomy and fusion with an intervertebral cage for cervical disc hernia. The angle of lordosis, segmental height and range of motion were evaluated preoperatively and postoperatively at 1 month and 2 years. The clinical outcome was assessed by the visual analog scale and Odom's criteria. RESULTS: The angle of lordosis increased by 2.62degrees and the range of motion angle increased by 5.14degrees after the operation. The segmental height did not change. The visual analog scale and Odom's criteria scores decreased significantly after the operation. CONCLUSIONS: Using a cage in anterior cervical discectomy prevents segmental collapse, so the segmental height and the angle of lordosis are preserved and newly-developed pain does not occur.