TITLE:
Giant Thoracic Cystic Intradural Extramedullary Schwannoma Causing Severe Abrupt Paraparesis: A Case Report and Review of the Literature
AUTHORS:
Oumar Coulibaly, Kouassi Jean Marie Maurin Kisito Quénum, Mahamadou Dama, Daouda Sissoko, Amadou Togo, Youssouf Sogoba, Moussa Diallo, Drissa Kanikomo, Oumar Diallo
KEYWORDS:
Intradural, Extramedullary, Cystic Schwannoma, Spinal Cord Compression
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.16 No.1,
December
30,
2025
ABSTRACT: Background: Spinal schwannomas represent approximately 20% - 30% of all spinal tumors and are the most common type of intradural extramedullary tumors. These slow-growing tumors arise from spinal nerve root sheaths and can cause progressive spinal cord compression, which is usually seen in many patients. They are mainly solid or heterogeneous in nature and can increase in size, undergo degenerative changes in some rare cases leading to cyst formation, hemorrhage, calcification, and hyalinization. However, pure cystic intradural extramedullary schwannomas are very rare and uncommon. The severity of these symptoms depends on the location and the size of the tumor on the spinal cord. The aim of this study is to describe an unusual manifestation of this tumor, to discuss the sudden deterioration observed in this case, and to emphasize the differential diagnosis. Case Presentation: We report a case of a giant cystic schwannoma in a 17-year-old girl revealed by a severe abrupt paraparesis. Magnetic resonance imaging revealed a huge intradural extramedullary lesion that extended from T10-T11 and caused a remarkable spinal cord compression. This lesion had been totally removed surgically and the postoperative course was uneventful. Conclusion: Cystic schwannomas are rare spinal lesions responsible for cord compression in some rare cases. If symptomatic, complete surgical resection associated with physiotherapy might be the goal despite the clinical stage of presentation.