Abstract
The patient, a 42-year-old female, was admitted with a 5-year history of progressive numbness of the bilateral lower limbs. Neurological examination disclosed left-sided weakness with hyperreflexia and hypesthesia under the Th4 level. Metrizamide myelography showed a severe cord swelling from C2 to C7. Metrizamide CT scan revealed a severe cord widening at the C5, 6 level and displacement of the cord and the anterior median fissure to the right side at the C6, 7 level. In addition, an exophytic extension to the left side at the C7 level was recognized. Laminectomy was performed from C2 through Th1. The tumor was located on the posterior surface of the spinal cord at the C4-6 levels and covered by the pia mater, and the left posterior root penetrated the tumor. Another tumor was found at the C7 level, in accordance with the pre-operative CT scan finding. The tumors were totally removed. Histopathological examination revealed a typical Antoni type A schwannoma. This case was a sub-pial schwannoma originating from the posterior root entry zone. Usage of the term “sub-pial” has been coined with the lipoma located under the pia mater. Nevertheless, the authors proposed that the present case should be classified as the spinal subpial tumor.
