Cervical schwannoma presenting as an expansile vertebral body lesion: report of two cases with a technical note on the surgical management

BackgroundSchwannoma causing invasion and osteolytic expansion of the vertebral body has been uncommonly noted in lumbar and thoracic regions, but has not been yet reported in the cervical spine. Our purpose is to discuss the surgically relevant anatomical features of cervical schwannomas associated with vetebral invasion, to review their imaging findings and briefly discuss the surgical strategies in managing these challenging lesions.Case DescriptionClinical and radiological follow-up in two patients is presented. Both tumors were successfully resected using an anterior approach with lateral extension. Pathology was diagnostic for a benign schwannoma, and at 1-year follow-up, both patients were asymptomatic with no recurrence.ConclusionIn conclusion, schwannoma should be included in the differential diagnosis of large, extradural mass causing expansion and destruction of the spine, especially with characteristic imaging findings such as neural foraminal widening and vertebral body scalloping. Aggressive surgical management with skeletonization of the vertebral artery may provide good technical and clinical outcome.