Dumbbell schwannoma complicated by intradural lumbar disc herniation at the same level—A rare case report

Abstract

Introduction: Dumbbell schwannoma complicated by intradural lumbar disc herniation at the same level is extremely rare. Case presentation: We describe a 67-year-old female presented with low back pain for 10 years and weakness and numbness of the right lower extremity for one month. Contrast magnetic resonance imaging (MRI) revealed an inhomogeneous enhanced dumbbell lesion at the L4/5 right intervertebral foramen and the intradural part of the lesion is only annular enhanced. A single posterior-approach surgery, including L4 laminectomy and right L4/5 facet joint resection, intracapsular resection of extradural dumbbell tumor, and intradural nucleus pulposus resection, was performed. The patient's back pain and weakness of right lower extremity disappeared. Histological studies revealed a schwannoma and a herniated disc. Conclusions: To our knowledge, this case is the first report of dumbbell schwannoma complicated by intradural lumbar disc herniation. Contrast MRI is helpful in preoperative differential diagnosis. Careful preoperative images reading are important to prevent misdiagnosis. Keywords: Dumbbell schwannoma, Intradural disc herniation, Resective surgery