Background: Spinal schwannomas are benign nerve sheath tumors that typically arise in the intradural extramedullary compartment but may occasionally mimic intramedullary lesions on magnetic resonance imaging (MRI). Case Description: A 43-year-old female presented with progressive upper-limb numbness and weakness, thoracic pain, and dysphagia. MRI showed an apparently intramedullary cervicothoracic lesion, characterized by spinal cord expansion, heterogeneous signal, and absence of clear margins with the cord. The patient underwent C7–D2 laminectomy and complete microsurgical resection of a highly vascularized extramedullary tumor. Histopathology confirmed schwannoma, and postoperative evolution was favorable without new deficits. Conclusion: Cervicodorsal schwannomas can simulate intramedullary tumors, posing a diagnostic challenge. Complete microsurgical resection through a posterior approach provides excellent outcomes.
Gutierrez et al. (Fri,) studied this question.