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Vol. 21. Issue 3.
Pages 232-238 (January 2010)
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Vol. 21. Issue 3.
Pages 232-238 (January 2010)
Neurinomas intramedulares. Presentación de dos casos de un tumor infrecuente
Intramedullary schwannomas. Report of two cases
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L.M. Bernal-García
Corresponding author
lumi_bega@hotmail.com

Correspondencia: Servicio de Neurocirugía. Hospital Universitario Infanta Cristina. Avenida de Elvas s/n. 06006 Badajoz.
, J.M. Cabezudo-Artero, M. Ortega-Martínez, L.F. Porras-Estrada, I. Fernández-Portales, L.F. Ugarriza-Echebarrieta, M. Molina-Orozco
Servicios de Neurocirugía. Hospital Universitario Infanta Cristina. Badajoz
J.J. Pimentel-Leo*
* Servicios de Neurocirugía y de Anatomía Patológica. Hospital Universitario Infanta Cristina. Badajoz
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Resumen

Los schwannomas intramedulares son tumores benignos derivados de células de Schwann localizadas en el parénquima medular. Son muy infrecuentes, constituyendo entre el 0,3 y el 1,5% de los schwannomas espinales. Existen varias teorías que intentan explicar la presencia de células de Schwann intramedulares a partir de las que derivarían estas neoplasias. La sintomatología no es específica, siendo el dolor el síntoma más frecuente, pudiéndose añadir, además, cualquier signo de afectación medular según el nivel de localización. En las pruebas de neuroimagen, la sospecha de otras lesiones intramedulares de origen glial más frecuentes hace que el diagnóstico de schwannoma intramedular sea postquirúrgico la mayoría de las veces. El tratamiento es quirúrgico, pudiendo llevarse a cabo, habitualmente, una resección completa.

En este artículo presentamos dos casos de pacientes intervenidas quirúrgicamente de sendas lesiones intramedulares, que resultaron ser neurinomas. Hacemos una revisión de otros casos publicados en la literatura, exponiendo las teorías existentes acerca del origen de estos tumores poco frecuentes.

Palabras clave:
Célula de Schwann
Neurinoma intramedular
Schwannoma
Tumor espinal
Tumor intramedular
Abreviaturas:
EEII
GFAP
NF
RM
TC
Summary

Intramedullary schwannomas are benign tumors that arise from clusters of Schwann cells embedded in the medullary parenchyma. They are very rare and account for 0.3 to 1.5% of all spinal schwannomas. It is not known for certain why this happens, and several theories have been put forward. They do not exhibit any characteristic clinical picture, being pain the most frequent symptom. Imaging is also not specific and the correct diagnosis is attained most of the times after pathological examination. The goal of treatment must be complete removal, which is curative.

We are presenting two patients in whom an intramedullary tumor was removed. The true nature of the lesions was suspected during the operation, but only after pathological examination was confirmed. A review of the literature has been undertaken, with special attention to the theories about the origin of these uncommon tumors.

Key words:
Schwann cell
Intramedullary neurinoma
Schwannoma
Spinal tumor
Intramedullary tumor

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