Large Anterior Cervical Spine Schwannoma Causing Dysphagia: Case Report

Aleksander Joniec, Jedrzej Mikolajczyk, Bartosz Godlewski Department of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed – St. Raphael Hospital, Cracow, PolandCorrespondence: Aleksander Joniec, Department of Orthopaedics and Traumatology, with Spinal Surgery Ward, Scanmed – St. Raphael Hospital, ul. Adama Bochenka 12, Cracow, 30-693, Poland, Email [email protected]: Schwannomas are rare benign tumours of Schwann cell origin that rarely undergo malignant transformation and are most often (25– 45%) found in the head and neck region. We present a case of a large schwannoma arising directly from the anterior aspect of the cervical spine (C6-C7-Th1) that caused considerable oesophageal displacement and compression, manifesting as dysphagia.Case Report: A 52-year-old male patient sought medical advice on account of intermittent dysphagia and a sense of pressure in the neck, in the absence of pain or neurological deficits. A magnetic resonance (MRI) scan and a subsequent open/surgical biopsy revealed a large schwannoma on the anterior aspect of the spine at C6-C7-Th1 causing compression of the oesophagus. Following a neurosurgical consultation, a radical gross resection of the tumour was carried out from an anterior approach, with no neurological complications. A histological examination of the tumour confirmed the initial diagnosis and a follow-up MRI scan demonstrated complete resection.Conclusion: This case of successful treatment of a large schwannoma at the C6-C7-Th1 level highlights the importance of both MR imaging and biopsy in pre-operative planning. An anterior approach, routinely employed in cervical spine surgery, made it possible to perform a radical resection without neurological complications or the need to stabilise the cervical spine, which expedited the patient’s return to full fitness.Keywords: schwannoma, dysphagia, cervical spine, anterior approach