{"id":"71a6c9a6-e197-4467-9e49-fd5e96355dd0","slug":"cervical-intradural-intramedullary-collision-tumor-of-schwannoma-and-hemangioblastoma-origin","title":"Cervical intradural intramedullary collision tumor of schwannoma and hemangioblastoma origin","authors":["Rohin Singh","Maziyar Kalani"],"abstract":"Background: Primary spinal tumors are rare benign lesions that represent around 2–4% of all central nervous system neoplasms.[1,2] Intradural intramedullary tumors are predominately glial in origin and are most commonly astrocytomas or ependymomas. Intradural extramedullary tumors, on the other hand, are usually neurofibromas, schwannomas, or meningiomas.[2] Here, we report the case of an intradural intramedullary collision tumor of schwannoma-hemangioblastoma origin. Case Description: A 61-year-old female presented with a 2-year history of the right arm numbness, weakness, and tingling. She reported some lower extremity numbness but an otherwise normal neurological examination. She had a prior carpal tunnel release that did not alleviate her symptoms. Noncontrast MRI of the cervical spine demonstrated a holocord syrinx from C2 to C7 and spondylolisthesis from C4 to C5. MRI with contrast then displayed an enhancing nodule behind the vertebral body of C4. A standard posterior approach and subperiosteal dissection were performed. Lateral mass screws were placed at C3-C5, and the laminectomy was performed en bloc. Intraoperative ultrasound was used to locate the lesion, and intraoperative dorsal column mapping was used to identify the midline before performing a midline myelotomy. The arachnoid over the lesion was opened and an extracapsular dissection was performed. Hemostasis was obtained, and a watertight dural closure was performed. Conclusion: The patient tolerated the procedure well and achieved relief from cervical myelopathy symptoms. Pathology indicated positive biomarkers for S-100, SOX10, and NSE indicating a schwannoma hemangioblastoma collision tumor. This is unusual in its nature given two benign lesions with differing underlying cell types of origin. 0:32 – Pre-operative imaging findings. 1:17 – Risks and benefits of procedure. 4:54 – Disease background. 5:30 – Post-operative imaging findings. Patient’s consent not required as patients identity is not disclosed or compromised. There are no conflicts of interest. www.surgicalneurologyint.com","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/spine.png","publishDate":"2021-04-14T00:00:00.000Z","doi":"10.25259/SNI_92_2021","categories":["Spine","Video Abstract"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/71a6c9a6-e197-4467-9e49-fd5e96355dd0/pdf"}