Intradural Schwannoma Presenting as Radiculopathy

許旺氏細胞瘤是一種常見的脊髓腫瘤，其症狀大多以疼痛表現為主，而這有時容易與一些常見造成背痛的病因（例如，退化性的脊椎疾病）混淆，而導致延遲診斷。如果是發生在僵直性脊椎炎的病患，情況將會更複雜。一位50歲的男性病患，主訴右側中段背部疼痛數個月，且疼痛範圍是依神經根的走向分布。起初被診斷可能為退化性脊椎疾病或僵直性脊椎炎引起之接骨點發炎，而接受藥物及復健治療，症狀卻無改善。病患至本院就診，神經學檢查發現右側T6～T10區域有感覺異常徵兆。進一步安排核磁共振檢查，發現胸椎第8節硬膜內有一腫瘤病灶，在T1 weight影像下呈現中等訊號，在T2 weight影像則呈現高訊號。會診神經外科醫師後進行手術切除，病理診斷為許旺氏細胞瘤，而病患疼痛症狀亦在術後獲得解除。由此病例可以了解，許旺氏細胞瘤的臨床表現容易與其他常見疾病有所混淆，臨床醫師以提高警覺並加以區別，早期診斷。

關鍵字

神經根病變；許旺氏細胞瘤；脊髓腫瘤；背痛

並列摘要

Schwannoma is a common spinal tumor. The most common initial presentation is pain and this may be confused with degenerative spinal diseases. Moreover, this disease seems to be more difficult to diagnose in patients when the diagnosis is complicated by ankylosing spondylitis. A 50-year-old male patient presented with right mid-back pain with a root distribution. He was first treated as subacute radiculopathy resulting from a degenerative disease or enthesitis resulting from ankylosing spondylitis. Due to treatment failure when anti-inflammatory agents and physical therapy were prescribed, he visited our clinic and a survey was carried out. A neurological examination disclosed right T6-T10 hyperesthesia. Magnetic resonance imaging was arranged and showed a mass at the T8 level with high signal intensity on T2-weighted imaging, and low signal intensity on T1-weighted imaging. Resectioning of the tumor was performed and the symptoms were relieved after removal. It is important to differentiate between schwannoma and other diseases with a similar presentation. A better outcome is more likely with an earlier diagnosis.

並列關鍵字

Radiculopathy ； schwannoma ； spinal cord neoplasm ； back pain

國際替代計量

Intradural Schwannoma Presenting as Radiculopathy

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