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Vol. 26. Issue 1.
Pages 39-42 (January - February 2015)
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Vol. 26. Issue 1.
Pages 39-42 (January - February 2015)
Caso clínico
Tumor elusivo dorsal. Presentación de un caso excepcional y revisión de la bibliografía
Elusive thoracic spine tumour. Report of an exceptional case and literature review
Marcos Botana-Fernándeza,
Corresponding author
marcosbotana1980@hotmail.com

Autor para correspondencia.
, José Manuel Cabezudo-Arteroa, Manuel Royano-Sáncheza, Rafael García-Morenoa, Eduardo Murias-Quintanab, Marta Ortega-Martínezc
a Servicio de Neurocirugía, Complejo Hospitalario Universitario de Badajoz, Badajoz, España
b Servicio de Radiología, Hospital Universitario Central de Asturias, Oviedo, Asturias, España
c Servicio de Neurocirugía, Hospital Universitario San Pedro de Alcántara, Cáceres, España
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Resumen

Los tumores elusivos espinales han sido descritos en la literatura científica previamente. En la mayoría de los casos se trata de neurinomas de la cauda equina.

Presentamos el caso de una mujer cuyo diagnóstico radiológico de presunción es el de neurinoma a nivel D10.

Se decide extirpación microquirúrgica de la lesión, y tras la laminectomía, correctamente emplazada, no se encuentra el tumor.

El reporte de tumores espinales intradurales extramedulares con desplazamiento en el espacio subaracnoideo es muy infrecuente, siendo a nivel dorsal excepcional.

Es difícil predecir los casos en los que este extraño fenómeno pueda darse, pero parecen una constante los cambios en la clínica del paciente según la posición, el pequeño tamaño de la lesión y la escasa adherencia a estructuras vecinas.

El neurocirujano debe disponer de los recursos necesarios para solventar una exploración en blanco tras la laminectomía, llegado el caso.

Palabras clave:
Dorsal neurinoma
Schwannoma
Espinal
Móvil
Elusivo
Laminectomía
Abstract

Elusive tumours in the spine, most of them schwannomas of the cauda equina, have been reported very rarely.

We present the case of a woman with a preoperative radiological diagnosis of schwannoma at D10 level in whom a laminectomy was performed to remove the tumour.

Although the laminectomy was correctly positioned, there was no tumour upon opening the dura and the laminectomy had to be extended cephalad to find and remove the tumour.

Mobile intradural extramedullary spinal tumours, the so-called «elusive tumours», occur very rarely, and it is exceptional when they are located in the thoracic spine.

Knowing preoperatively which tumour is going to behave in this way is almost impossible. However, in the reported cases there are common features such as symptoms changing with different body positions, small tumour size and weak attachment to nearby structures.

Neurosurgeons must be able to resolve this situation when confronted with a negative correctly-positioned laminectomy.

Keywords:
Neurinoma
Schwannoma
Spinal
Mobile
Elusive
Laminectomy

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