TORAKAL BÖLGEDE HALTER SCHWANNOM CERRAHİSİNDE POSTERİOR YAKLAŞIM: OLGU SUNUMU

Year 2009, Volume: 10 Issue: 1, 41 - 44, 01.04.2009

Soner Yaycıoğlu Hakan Ak Süleyman Damgacı Halil Samancıoğlu S. Savaş Yalçın

Abstract

Schwannomlar periferik sinir kılıfı schwann hücrelerinden gelişirler ve iyi huylu yumuşak doku tümörlerinin%5'ini oluştururlar. Ekstramedüller yerleşimli bu tümörler bazen omurilik sinir köklerini takip ederekintervertebral foramenden çıkar ve kum saati veya halter şeklinde kitle meydana getirirler. Torakal bölgede haltertarzı schwannomlarda çeşitli cerrahi yaklaşımlar uygulanabilmektedir. En sık kullanılan girişim posterioryaklaşımla laminektomi ve kostotransversektomidir. Ancak bazı otörler bu girişimin ekstraspinal kısımlarınrezeksiyonu için yetersiz kalacağını ve torakotomi eklenmesi gerekliliğini vurgulamaktadır. 35 yaşında torakal11 halter schwannomu olan bir bayan olgu sunulmuştur. Posterior girişimle laminektomi ve minimalkostotransversektomi yapılarak iyi sınırlı tümör total olarak çıkarılmıştır. Bu tür tümörlerde sadece posteriorgirişimin yeterli olduğu, anterior ya da posterolateral girişimlerin daha büyük ve invazif olan diğer halter tarzıgörünüm veren tümörler için önerilebileceği düşünülmektedir

Keywords

Schwannom, torakal omurga, instabilite, laminektomi

Posterior Surgical Approach to Dumbbell Schwannoma at Thoracic Vertabrae Level: A Case Report

Abstract

Schwannomas originate from schwann cells of peripheral nerve sheats and account for 5% of benign soft tissue tumors. These tumors located extramedullary, sometimes may exit from intervertebral foramina and following the the spinal nerve roots may lead to dumbbell shaped mass. Several different surgical approaches can be used to operate these dumbbell tumors. Most commonly used approach is the laminectomy and costotransversectomy with posterior approach. But some authors propose that this approach is not enough to remove extraspinal parts of the tumor, emphasizing the necessity of thoracotomy.We present a 35 year old woman with a dumbbell shaped schwannoma at Th11 level. The tumor completely was removed with posterior approach by laminectomy and minimal costotransversectomy.We propose that only posterior approach may be enough to remove these tumors, and anterior or posterolateral approaches may be prefered in bigger and more invasive dumbbell tumors.

Keywords

Schwannoma, thoracic vertebrae, instability, laminectomy

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