Chang-Hyun Lee, Chun Kee Chung, Seung-Jae Hyun, Chi Heon Kim, Ki-Jeong Kim, Tae-Ahn Jahng


October 2015, Volume 24, Issue 10, pp 2126 - 2132 Original Article Read Full Article 10.1007/s00586-015-4075-y

First Online: 25 June 2015

Purpose

Spinal intradural extramedullary (IDEM) schwannoma diagnosed by magnetic resonance (MR) imaging is sometimes detected incidentally. Because the natural history of spinal IDEM schwannoma has not been established well, questions remain regarding whether small and asymptomatic tumour has to be removed. We aimed to assess the natural history of spinal schwannoma diagnosed by MR imaging using an accurate and reliable method.

Methods

All patients who were diagnosed with spinal IDEM schwannoma by MR imaging and did not undergo surgical resection immediately were recruited. A number of 56 tumours were enrolled finally. Tumour volume was measured using the volume quantification method from the baseline through the final follow-up. Receiver operating characteristics plots were used to define cut-off value of discrimination.

Results

The probable schwannoma grew 5.45 % [median value of volumetric growth rate (VGR); interquartile range 0.14–14.19] annually with a mean surveillance interval of 43.6 months. Of the 56 tumours, some tumours kept growing rapidly and the others did not. The median annual VGR of the growing and stable probable schwannomas was 13.02 and −0.09 %, respectively (P 

Conclusions

Spinal probable IDEM schwannoma grew 5.45 % of the tumour volume annually and can be divided into growing and stable tumours. The tumour that grows ≥2.5 % of volume per year needs a careful inspection because it may be not benign schwannoma and keep growing continuously.


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