Unwinding the Spine: Advanced Diagnostic and Surgical Strategies for Lumbar Dumbbell Schwannoma

CASE REPORT
Flaka Pasha, Lavdim Ymeri, Berat Elshani, Blana Krasniqi, Art Uka

 
For citation: Pasha F, Ymeri L, Elshani B, Krasniqi B, Uka A. Unwinding the Spine: Advanced Diagnostic and Surgical Strategies for Lumbar Dumbbell Schwannoma . International Journal of Biomedicine. 2025;15(3):594-597. doi:10.21103/Article15(3)_CR2
 
Originally published September 5, 2025

Abstract: 

We present a rare case of a lumbar dumbbell-shaped schwannoma in a 36-year-old male with persistent lumbar pain and paresthesia. MRI revealed a contrast-enhancing mass at L3–L4 compressing the right L3 nerve root. A combined posterior and retroperitoneal approach enabled complete resection. Histopathology confirmed schwannoma with Antoni A/B areas and S-100 positivity. Postoperatively, the patient had full symptom resolution and no recurrence at three months. This case highlights the importance of timely diagnosis, imaging, and surgical resection for symptom relief and definitive diagnosis in managing lumbar dumbbell schwannomas, with adjunct therapies considered for incomplete or inoperable cases.

Keywords: 
lumbar dumbbell schwannoma • spinal tumor • MRI • surgical resection • postoperative management
References: 
  1. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW. The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016 Jun;131(6):803-20. doi: 10.1007/s00401-016-1545-1. Epub 2016 May 9. PMID: 27157931.
  2. Budiman Gondowardojo YR, Ompusunggu SE, Dahlan RH. Giant invasive lumbosacral spinal schwannoma. Neurol Spinal Med Chirurg. 2022;5(2):106. doi:10.4103/nsmc.nsmc_6_22.
  3. Rong HT, Fan YS, Li SP, Zhang ZS, Liu H, Liu T, Zhu T, Zhang JN. Management of Dumbbell and Paraspinal Tumors of the Thoracic Spine Using a Single-stage Posterolateral Approach: Case Series. Orthop Surg. 2018 Nov;10(4):343-349. doi: 10.1111/os.12405. Epub 2018 Nov 8. PMID: 30406971; PMCID: PMC6594492.
  4. Cleveland Clinic. Schwannoma: what it is, causes, symptoms & treatment [Internet]. [cited 2025 Jan 5]. Available from: https://my.clevelandclinic.org/health/diseases/17877-schwannoma
  5. Lenzi J, Anichini G, Landi A, Piciocchi A, Passacantilli E, Pedace F, Delfini R, Santoro A. Spinal Nerves Schwannomas: Experience on 367 Cases-Historic Overview on How Clinical, Radiological, and Surgical Practices Have Changed over a Course of 60 Years. Neurol Res Int. 2017;2017:3568359. doi: 10.1155/2017/3568359. Epub 2017 Sep 18. PMID: 29075532; PMCID: PMC5624174.
  6. Chu EC, Trager RJ, Yee WJ, Ng KK. Lumbar Schwannoma as a Rare Cause of Radiculopathy in the Chiropractic Office: A Case Report. Cureus. 2022 Nov 21;14(11):e31758. doi: 10.7759/cureus.31758. PMID: 36569702; PMCID: PMC9771692.
  7. Yang JJ, Landier W, Yang W, Liu C, Hageman L, Cheng C, Pei D, Chen Y, Crews KR, Kornegay N, Wong FL, Evans WE, Pui CH, Bhatia S, Relling MV. Inherited NUDT15 variant is a genetic determinant of mercaptopurine intolerance in children with acute lymphoblastic leukemia. J Clin Oncol. 2015 Apr 10;33(11):1235-42. doi: 10.1200/JCO.2014.59.4671. Epub 2015 Jan 26. PMID: 25624441; PMCID: PMC4375304.
  8. Strong MJ, Yee TJ, Khalsa SSS, Saadeh YS, Muhlestein WE, North RY, Szerlip NJ. Resection of a Lumbar Intradural Extramedullary Schwannoma: 2-Dimensional Operative Video. Oper Neurosurg (Hagerstown). 2021 Jun 15;21(1):E38. doi: 10.1093/ons/opab097. PMID: 33825885.
  9. Conti P, Pansini G, Mouchaty H, Capuano C, Conti R. Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol. 2004 Jan;61(1):34-43; discussion 44. doi: 10.1016/s0090-3019(03)00537-8. PMID: 14706374.
  10. Columbia Neurosurgery. Spinal schwannoma diagnosis & treatment—NYC [Internet]. 2021 Apr 8 [cited 2025 Jan 5]. Available from: https://www.neurosurgery.columbia.edu/patient-care/conditions/spinal-sch...
  11. Gui C, Canthiya L, Zadeh G, Suppiah S. Current state of spinal nerve sheath tumor management and future advances. Neurooncol Adv. 2024 Jul 17;6(Suppl 3):iii83-iii93. doi: 10.1093/noajnl/vdae067. PMID: 39430389; PMCID: PMC11485951.
  12. D'Andrea G, Sessa G, Picotti V, Raco A. One-Step Posterior and Anterior Combined Approach for L5 Retroperitoneal Schwannoma Eroding a Lumbar Vertebra. Case Rep Surg. 2016;2016:1876765. doi: 10.1155/2016/1876765. Epub 2016 Sep 27. PMID: 27766176; PMCID: PMC5059541.
  13. Hwang L, Okoye CC, Patel RB, Sahgal A, Foote M, Redmond KJ, Hofstetter C, Saigal R, Mossa-Basha M, Yuh W, Mayr NA, Chao ST, Chang EL, Lo SS. Stereotactic body radiotherapy for benign spinal tumors: Meningiomas, schwannomas, and neurofibromas. J Radiosurg SBRT. 2019;6(3):167-177. PMID: 31998537; PMCID: PMC6774487.
  14. Senapati SB, Mishra SS, Dhir MK, Patnaik A, Panigrahi S. Recurrence of spinal schwannoma: Is it preventable? Asian J Neurosurg. 2016 Oct-Dec;11(4):451. doi: 10.4103/1793-5482.145060. PMID: 27695564; PMCID: PMC4974985.
  15. Takashima H, Takebayashi T, Yoshimoto M, Onodera M, Terashima Y, Iesato N, Tanimoto K, Ogon I, Morita T, Yamashita T. Differentiating spinal intradural-extramedullary schwannoma from meningioma using MRI T2 weighted images. Br J Radiol. 2018 Dec;91(1092):20180262. doi: 10.1259/bjr.20180262. Epub 2018 Aug 7. PMID: 30052467; PMCID: PMC6319836.
  16. Argiti K, Watzlawick R, Hohenhaus M, Vasilikos I, Volz F, Roelz R, Scholz C, Hubbe U, Beck J, Neef M, Klingler JH. Minimally invasive tubular removal of spinal schwannoma and neurofibroma - a case series of 49 patients and review of the literature. Neurosurg Rev. 2024 Aug 10;47(1):418. doi: 10.1007/s10143-024-02656-x. PMID: 39123090; PMCID: PMC11315786.

Download Article
Received June 11, 2025.
Accepted July 18, 2025.
©2025 International Medical Research and Development Corporation.