Case Report: Intraosseous schwannoma of the thoracic spine: two case reports and an updated review of the literature

TL;DR

This paper reports two rare cases of intraosseous schwannoma in the thoracic spine and reviews the literature to improve understanding and diagnosis of this uncommon tumor.

Contribution

The paper contributes two new case reports of intraosseous schwannoma in the thoracic spine and provides updated insights into its diagnosis and treatment.

Findings

Intraosseous schwannomas at T2 and T8 vertebrae showed characteristic imaging features like expansile lytic lesions and foraminal widening.

Complete tumor resection is recommended, with spinal fusion often needed for reconstruction.

Recurrence is uncommon after surgical treatment.

Abstract

Intraosseous schwannomas (IOSs) are benign tumors composed of nerve sheath cells, representing less than 0.2% of primary bone tumors. These tumors most commonly affect the mandible and sacrum, while vertebral involvement remains exceedingly rare. Herein, we present two cases of SISs located at the T2 and T8 vertebrae. We detail the clinical presentation, imaging features, histopathological characteristics, and surgical management of SISs to advance the understanding of this rare condition. Typically presenting as expansile lytic lesions with sclerotic margins, lacking periosteal reaction or calcification, SISs frequently cause foraminal widening and vertebral scalloping, which are characteristic imaging findings that differentiate them from other bone tumors. Complete tumor resection is the recommended treatment, and spinal fusion is often necessary for reconstruction, with recurrence being uncommon after surgery. Additionally, we conduct a review of the existing literature and engage in a discussion regarding this uncommon tumor, enriching clinicians’ differential diagnosis of vertebral body osteolytic lesions and providing valuable clinical experience for the individualized selection of surgical approaches.

Figures