Lumbar intradural extramedullary plexiform schwannoma: A case report and literature review

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Background: Plexiform schwannomas are rare lesions with different histopathological variants (i.e., multifocal, intraneural, and multinodular). They comprise ~5% of schwannomas and rarely occur in the spinal canal. Here, a 40-year-old male presented with an exceedingly rare plexiform schwannoma. Case Description: A 40-year-old male presented with low back pain, bilateral L3 radiculopathy, and mild L3-level hypoesthesias. The pre-operative lumbar magnetic resonance imaging (MRI) showed an intradural extramedullary, multinodular L3 mass, isointense on T1-weighted imaging, homogeneously hyperintense on T2-weighted imaging, and markedly enhancing with contrast. Gross total microsurgical resection was achieved through an L3 laminectomy. The histopathology revealed a plexiform schwannoma (World Health Organization Grade 1). The post-operative MRI confirmed complete tumor removal, and six months later, the patient remained asymptomatic. Conclusion: Microsurgical gross total resection is the mainstay treatment for rare symptomatic lumbar plexiform schwannomas.

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