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Schwannoma
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Neurofibromatosis type 2 (NF2)
                  • Multiple inherited schwannomas, meningiomas, and ependymomas (MISME)
              • Synonyms

                • Neurinoma, neurilemmoma (outdated terms)
                • Nerve sheath tumor (NST)
              • Definitions

                • Neoplasm of nerve sheath (Schwann cells)

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Angiographic Findings

                        • Nonvascular Interventions

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Staging, Grading, & Classification

                                  • Gross Pathologic & Surgical Features

                                    • Microscopic Features

                                      CLINICAL ISSUES

                                      • Presentation

                                        • Demographics

                                          • Natural History & Prognosis

                                            • Treatment

                                              DIAGNOSTIC CHECKLIST

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Tish S et al: The epidemiology of spinal schwannoma in the United States between 2006 and 2014. J Neurosurg Spine. 1-6, 2019
                                                2. Ardern-Holmes S et al: Neurofibromatosis type 2. J Child Neurol. 32(1):9-22, 2017
                                                3. Gu BS et al: Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine. Eur Spine J. 24(10):2114-8, 2015
                                                4. Kukreja S et al: Cauda equina schwannoma presenting with intratumoral hemorrhage and intracranial subarachnoid hemorrhage. J Neurosurg Spine. 21(3):357-60, 2014
                                                5. Netra R et al: Spinal cystic schwannoma: an MRI evaluation. J Coll Physicians Surg Pak. 24(2):145-7, 2014
                                                6. Vadivelu S et al: Giant invasive spinal schwannoma in children: a case report and review of the literature. J Med Case Rep. 7:289, 2013
                                                7. Murovic JA et al: Foraminal nerve sheath tumors: intermediate follow-up after cyberknife radiosurgery. Neurosurgery. 64(2 Suppl):A33-43, 2009
                                                8. Ozawa H et al: Spinal dumbbell tumors: an analysis of a series of 118 cases. J Neurosurg Spine. 7(6):587-93, 2007
                                                9. Dodd RL et al: CyberKnife radiosurgery for benign intradural extramedullary spinal tumors. Neurosurgery. 58(4):674-85; discussion 674-85, 2006
                                                10. Conti P et al: Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol. 61(1):34-43; discussion 44, 2004
                                                11. Colosimo C et al: Magnetic resonance imaging of intramedullary spinal cord schwannomas. Report of two cases and review of the literature. J Neurosurg. 99(1 Suppl):114-7, 2003
                                                12. Hasegawa M et al: Surgical pathology of spinal schwannomas: a light and electron microscopic analysis of tumor capsules. Neurosurgery. 49(6):1388-92; discussion 1392-3, 2001
                                                13. Sridhar K et al: Giant invasive spinal schwannomas: definition and surgical management. J Neurosurg. 94(2 Suppl):210-5, 2001
                                                14. Woodruff JM et al: Schwannoma. In Kleihues P et al: Tumors of the Nervous System. Lyon: IARC Press. 164-6, 2000
                                                15. Murphey MD et al: From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics. 19(5):1253-80, 1999
                                                16. Vallat-Decouvelaere AV et al: Spinal melanotic schwannoma: a tumour with poor prognosis. Histopathology. 35(6):558-66, 1999
                                                17. Mautner VF et al: Spinal tumors in patients with neurofibromatosis type 2: MR imaging study of frequency, multiplicity, and variety. AJR Am J Roentgenol. 165(4):951-5, 1995
                                                18. Akeson P et al: Radiological investigation of neurofibromatosis type 2. Neuroradiology. 36(2):107-10, 1994
                                                19. Matsumoto S et al: MRI of intradural-extramedullary spinal neurinomas and meningiomas. Clin Imaging. 17(1):46-52, 1993
                                                20. Friedman DP et al: Intradural schwannomas of the spine: MR findings with emphasis on contrast-enhancement characteristics. AJR Am J Roentgenol. 158(6):1347-50, 1992
                                                21. Shen WC et al: Cystic spinal neurilemmoma on magnetic resonance imaging. Neuroradiology. 34(5):447-8, 1992
                                                22. Demachi H et al: MR imaging of spinal neurinomas with pathological correlation. J Comput Assist Tomogr. 14(2):250-4, 1990
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Neurofibromatosis type 2 (NF2)
                                                                • Multiple inherited schwannomas, meningiomas, and ependymomas (MISME)
                                                            • Synonyms

                                                              • Neurinoma, neurilemmoma (outdated terms)
                                                              • Nerve sheath tumor (NST)
                                                            • Definitions

                                                              • Neoplasm of nerve sheath (Schwann cells)

                                                            IMAGING

                                                            • General Features

                                                              • Radiographic Findings

                                                                • CT Findings

                                                                  • MR Findings

                                                                    • Angiographic Findings

                                                                      • Nonvascular Interventions

                                                                        • Imaging Recommendations

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Staging, Grading, & Classification

                                                                                • Gross Pathologic & Surgical Features

                                                                                  • Microscopic Features

                                                                                    CLINICAL ISSUES

                                                                                    • Presentation

                                                                                      • Demographics

                                                                                        • Natural History & Prognosis

                                                                                          • Treatment

                                                                                            DIAGNOSTIC CHECKLIST

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Tish S et al: The epidemiology of spinal schwannoma in the United States between 2006 and 2014. J Neurosurg Spine. 1-6, 2019
                                                                                              2. Ardern-Holmes S et al: Neurofibromatosis type 2. J Child Neurol. 32(1):9-22, 2017
                                                                                              3. Gu BS et al: Surgical strategies for removal of intra- and extraforaminal dumbbell-shaped schwannomas in the subaxial cervical spine. Eur Spine J. 24(10):2114-8, 2015
                                                                                              4. Kukreja S et al: Cauda equina schwannoma presenting with intratumoral hemorrhage and intracranial subarachnoid hemorrhage. J Neurosurg Spine. 21(3):357-60, 2014
                                                                                              5. Netra R et al: Spinal cystic schwannoma: an MRI evaluation. J Coll Physicians Surg Pak. 24(2):145-7, 2014
                                                                                              6. Vadivelu S et al: Giant invasive spinal schwannoma in children: a case report and review of the literature. J Med Case Rep. 7:289, 2013
                                                                                              7. Murovic JA et al: Foraminal nerve sheath tumors: intermediate follow-up after cyberknife radiosurgery. Neurosurgery. 64(2 Suppl):A33-43, 2009
                                                                                              8. Ozawa H et al: Spinal dumbbell tumors: an analysis of a series of 118 cases. J Neurosurg Spine. 7(6):587-93, 2007
                                                                                              9. Dodd RL et al: CyberKnife radiosurgery for benign intradural extramedullary spinal tumors. Neurosurgery. 58(4):674-85; discussion 674-85, 2006
                                                                                              10. Conti P et al: Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol. 61(1):34-43; discussion 44, 2004
                                                                                              11. Colosimo C et al: Magnetic resonance imaging of intramedullary spinal cord schwannomas. Report of two cases and review of the literature. J Neurosurg. 99(1 Suppl):114-7, 2003
                                                                                              12. Hasegawa M et al: Surgical pathology of spinal schwannomas: a light and electron microscopic analysis of tumor capsules. Neurosurgery. 49(6):1388-92; discussion 1392-3, 2001
                                                                                              13. Sridhar K et al: Giant invasive spinal schwannomas: definition and surgical management. J Neurosurg. 94(2 Suppl):210-5, 2001
                                                                                              14. Woodruff JM et al: Schwannoma. In Kleihues P et al: Tumors of the Nervous System. Lyon: IARC Press. 164-6, 2000
                                                                                              15. Murphey MD et al: From the archives of the AFIP. Imaging of musculoskeletal neurogenic tumors: radiologic-pathologic correlation. Radiographics. 19(5):1253-80, 1999
                                                                                              16. Vallat-Decouvelaere AV et al: Spinal melanotic schwannoma: a tumour with poor prognosis. Histopathology. 35(6):558-66, 1999
                                                                                              17. Mautner VF et al: Spinal tumors in patients with neurofibromatosis type 2: MR imaging study of frequency, multiplicity, and variety. AJR Am J Roentgenol. 165(4):951-5, 1995
                                                                                              18. Akeson P et al: Radiological investigation of neurofibromatosis type 2. Neuroradiology. 36(2):107-10, 1994
                                                                                              19. Matsumoto S et al: MRI of intradural-extramedullary spinal neurinomas and meningiomas. Clin Imaging. 17(1):46-52, 1993
                                                                                              20. Friedman DP et al: Intradural schwannomas of the spine: MR findings with emphasis on contrast-enhancement characteristics. AJR Am J Roentgenol. 158(6):1347-50, 1992
                                                                                              21. Shen WC et al: Cystic spinal neurilemmoma on magnetic resonance imaging. Neuroradiology. 34(5):447-8, 1992
                                                                                              22. Demachi H et al: MR imaging of spinal neurinomas with pathological correlation. J Comput Assist Tomogr. 14(2):250-4, 1990