Microsurgical Resection of a Giant Lumbar Intraspinal Tumor with Retroperitoneal Extension

Large intraspinal tumor with significant extra-spinal extension is rare entities, posing considerable surgical challenges. This was the case of an exceptionally large lumbar intraspinal tumor with retroperitoneal extension, highlighting the surgical management and favorable patient outcome. A 56-year-old female presented with lower back pain. Clinical examination revealed no focal neurological deficit or peripheral neurovascular deficits. Imaging revealed an extensive lumbar intraspinal tumor extending into the retroperitoneal space, measuring approximately 14 cm × 15 cm × 18 cm. The tumor occupied the spinal canal from D12 to L2 and extended laterally and anteriorly into the retroperitoneum, compressing adjacent structures. The patient underwent a complex surgical procedure involving collaboration between neurosurgeon, cardiothoracic surgeon, and urosurgeon. Gross total resection of the tumor was achieved. Histopathological analysis revealed Grade 1 schwannoma. Postoperatively, the patient experienced significant relief of preoperative symptoms. Importantly, there was no evidence of new neurological deficits or power loss. The patient was discharged home and has remained neurologically intact at follow-up. The surgical approach should be carefully planned to minimize the complications and achieve complete tumor removal. Postoperative care and long-term follow-up are crucial to ensure favorable outcomes and prevent recurrence.