{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T05:51:00Z","timestamp":1780638660650,"version":"3.54.1"},"reference-count":11,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:00:00Z","timestamp":1594425600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T00:00:00Z","timestamp":1594425600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2019M3E5D1A02068142"],"award-info":[{"award-number":["2019M3E5D1A02068142"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Musculoskelet Disord"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Plexiform schwannoma (PS), variant of schwannoma, often involves multiple fascicles as plexiform neurofibroma, and is usually located superficially on the dermis and subcutaneous layers. Spinal PS is extremely rare, and there is insufficient information on its natural course and treatment strategy. We describe the clinical features and treatment of giant intradural PS at the lumbosacral spine.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Case presentation<\/jats:title>\n<jats:p>A 66-year-old man presented with leg pain, paresthesia, and weakness for 2\u2009years. Magnetic resonance imaging demonstrated a large mass lesion involving a continuous multi-lobulated bead-like mass and a cystic portion from L1 to S3. The lesion was iso-intense on T2-weighted images (WI), iso- to slightly low-intense on T1-WI, and heterogeneous enhancement on contrast-enhanced T1-WI. The large mass lesion had three portions, including a cystic mass at L1, continuous multi-lobulated bead-like mass with a cystic portion from L2 to S1, and multi-lobulated mass from S2 to S3, which were identified with severe adhesions with cauda equina on operative assessment. Grossly total extirpation was achieved at the lumbar spine, and remained three round shaped small masses at the lumbar area and a multi-lobulated round masses from S2 to S3 involving nerves related with motor function of the lower extremities and anal sphincter, respectively. Histological examination revealed multinodular or plexiform growth pattern composed of spindle-shaped tumor cells, which were diffusely and strongly positive for S100 protein with KI67\u2009&lt;\u20091%. There were no recurrence of preoperative symptoms and changes of the remained masses over a 2-year follow-up period.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Subtotal extirpation to minimize neural deficits and close observation can be considered an appropriate treatment strategy for a giant spinal PS considering its benign prognosis and histological features, with a high risk of neurological damage during surgery.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12891-020-03492-y","type":"journal-article","created":{"date-parts":[[2020,7,11]],"date-time":"2020-07-11T14:03:01Z","timestamp":1594476181000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Giant intradural plexiform schwannoma of the lumbosacral spine - a case report and literature review"],"prefix":"10.1186","volume":"21","author":[{"given":"Dongwoo","family":"Yu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joon Hyuk","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1293-2724","authenticated-orcid":false,"given":"Ikchan","family":"Jeon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,7,11]]},"reference":[{"key":"3492_CR1","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/S0090-3019(03)00537-8","volume":"61","author":"P Conti","year":"2004","unstructured":"Conti P, Pansini G, Mouchaty H, Capuano C, Conti R. Spinal neurinomas: retrospective analysis and long-term outcome of 179 consecutively operated cases and review of the literature. Surg Neurol. 2004;61:34\u201343 discussion 4.","journal-title":"Surg Neurol"},{"key":"3492_CR2","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1227\/NEU.0b013e31824f4f96","volume":"71","author":"NH Yu","year":"2012","unstructured":"Yu NH, Lee SE, Jahng TA, Chung CK. Giant invasive spinal schwannoma: its clinical features and surgical management. Neurosurgery. 2012;71:58\u201366.","journal-title":"Neurosurgery."},{"key":"3492_CR3","first-page":"210","volume":"94","author":"K Sridhar","year":"2001","unstructured":"Sridhar K, Ramamurthi R, Vasudevan MC, Ramamurthi B. Giant invasive spinal schwannomas: definition and surgical management. 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Deep-seated plexiform schwannoma - a pathologic study of 16 cases and comparative analysis with the superficial variety. Am J Surg Pathol. 2005;29:1042\u20138.","journal-title":"Am J Surg Pathol"},{"key":"3492_CR7","doi-asserted-by":"publisher","first-page":"E611","DOI":"10.1097\/BRS.0b013e31815583b4","volume":"32","author":"H Sakaura","year":"2007","unstructured":"Sakaura H, Ohshima K, Iwasaki M, Yoshikawa H. Intra-extradural plexiform schwannoma of the cervical spine. Spine (Phila Pa 1976). 2007;32:E611\u20134.","journal-title":"Spine (Phila Pa 1976)"},{"key":"3492_CR8","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1016\/j.spinee.2014.09.005","volume":"15","author":"K Mori","year":"2015","unstructured":"Mori K, Imai S, Nishizawa K, Nakamura A, Ishida M, Matsusue Y. Plexiform schwannoma arising from cauda equina. Spine J. 2015;15:205\u20136.","journal-title":"Spine J"},{"key":"3492_CR9","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1080\/02688697.2016.1251573","volume":"31","author":"V Lam Shin Cheung","year":"2017","unstructured":"Lam Shin Cheung V, Provias J, Cenic A. Plexiform schwannoma of the thoracolumbar spine a rare clinical entity - a case report. Br J Neurosurg. 2017;31:279\u201381.","journal-title":"Br J Neurosurg"},{"key":"3492_CR10","doi-asserted-by":"publisher","first-page":"372","DOI":"10.3171\/2009.5.JNS09244","volume":"112","author":"MN Hebert-Blouin","year":"2010","unstructured":"Hebert-Blouin MN, Amrami KK, Scheithauer BW, Spinner RJ. Multinodular\/plexiform (multifascicular) schwannomas of major peripheral nerves: an underrecognized part of the spectrum of schwannomas. 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Hum Pathol. 2007;38:1096\u2013101.","journal-title":"Hum Pathol"}],"container-title":["BMC Musculoskeletal Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-020-03492-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12891-020-03492-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12891-020-03492-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,10]],"date-time":"2021-07-10T23:23:22Z","timestamp":1625959402000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmusculoskeletdisord.biomedcentral.com\/articles\/10.1186\/s12891-020-03492-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,7,11]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["3492"],"URL":"https:\/\/doi.org\/10.1186\/s12891-020-03492-y","relation":{},"ISSN":["1471-2474"],"issn-type":[{"value":"1471-2474","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7,11]]},"assertion":[{"value":"28 May 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 July 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 July 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the principles of the 1964 Declaration Helsinki and its later amendments or comparable ethical standards. Voluntary written informed consent was obtained prior to the study from the patients.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent for publication of this case report and any accompanying images was obtained from the patient. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"454"}}