A rare case of life-threatening giant plexiform schwannoma

A 28-year-old woman with idiopathic scoliosis presented with a cervical mass and progressive gait disturbance over the course of 2 years. Examination demonstrated mild spastic paraplegia, hypoesthesia with upper level at T5 and severe respiratory failure requiring assisted ventilation. Magnetic resonance imaging showed multiple thoracic masses compressing left lung, trachea, and spinal cord (Figure). Surgical resection was performed. Through C5–T1 laminectomy, the intradural part of the neoplasia was completely removed, and the extradural part was enucleated as much as possible. After surgery, the respiratory function improved. Histologic pattern and S100 protein diffuse reactivity were consistent with plexiform schwannoma, a rare benign cutaneous variation of schwannoma [1]. Although deep-seated plexiform schwannomas involving spinal cord are occasionally described [2], this case is undoubtedly impressive because of the lifethreatening tumor size (Figure).