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Year : 2021  |  Volume : 69  |  Issue : 6  |  Page : 1747--1752

Cervico Medullary Junction “Intramedullary Schwannoma” Masquerading As Glioma: A Surprise During Surgery

1 Department of Neurosurgery, KEM Hospital, Mumbai, Maharashtra, India; Advanced Endoscopic Skull Base And Lateral Skull Base, Italy
2 Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
3 Department of Pathology (Neuropathology Division), Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
4 Department of Neurosurgery, Dr. Rajendra Prasad, Govt. Medical College, Tanda, Himanchal Pradesh, India

Correspondence Address:
Dr. Manjul Tripathi
Dept. of Neurosurgery & Gamma Knife Radiosurgery, Functional Neurosurgery, Oxford University; Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.333465

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Background: Intramedullary schwannomas (IS) at cervicomedullary junction (CMJ) are exceedingly uncommon. There is hardly any clinicoradiological marker for preoperative diagnosis and prognostication. Case: We report a case of a 17-year-old boy with progressive spastic quadriparesis of six months duration. On radiology, there was a contrast-enhancing lesion expanding the cord extending from the medulla to C5 level. During surgery, the cord was expanded and the tumor was eccentric. Histopathology and immunohistochemistry were suggestive of schwannoma. In view of the ill-defined plane of separation from the normal neural tissue, only subtotal resection could be achieved. Conclusion: Schwannoma should be considered as a remote differential of intramedullary lesions. The extent of resection should be tailored according to the plane of dissection and intraoperative neuromonitoring guidance. Though a masquerader, schwannoma carries better prognosis than rest of the pathologies.


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