Zeki ŞEKERCİ, Habibullah DOLGUN, Erdal Reşit YILMAZ, Erhan TÜRKOĞLU, Hayri KERTMEN

İntradural ekstramedüller melanotik schwannom: Olgu sunumu

Melanotik schwannom nöroektodermal orjinli olup, schwann hücre stoplazmasının melanotik pigmentasyonu ile karakterizedir. Genellikle benign, yavaş büyüyen, kapsüllü ve nadir lezyonlardır. Bu çalışmada, iki aylık bel ve bacak ağrısı yakınması ile başvuran, nörolojik muayenesinde bilateral ayak dorsofl eksiyonu +4/5 motor kuvvetinde ve sol L5 dermatomunda hipoestezi olup lomber manyetik rezonans incelemesinde L4-L5 intradural ekstramedüller yerleşim gösteren kitle lezyonu saptanan 41 yaşında erkek hasta sunulmuştur. Embiryolojik gelişim esnasında nöral krestten göç eden hücreler melanositlere ve schwann hücrelerine dönüştüğü bilinmektedir. Tümoral dönüşüm gösteren schwann hücrelerinin melanin sentezleme özelliği kazandığına inanılmaktadır. Nadir görülen bu olgu ve manyetik rezonans görüntülemenin kesin ve erken tanıdaki önemi literatürler ışığında tartışılmıştır. Subtotal eksizyon yapılan olgulara radyoterapinin de kombine edilmesi önerilmektedir.

Intradural extramedullary melanotic schwannoma: Case report

Melanotic schwannomas are tumors of neural crest cells origin, characterized by cytoplasmic deposition of melanin. These tumors are rare and generally considered benign, capsulated. A 41- year old man presented with low-back and leg pain for two months. On neurological examination; his foot dorsofl exion muscle strenght was +4/5 (5/5) bilaterally and he had hemihypoesthesia on left L5 level .His magnetic resonance imaging scan revealed an intradural extramedullary lesion at the level of L4-L5. It is generally believed that, both schwann cells and melanocytes are derived from migrating neural crest cells. Perhaps schwann cells were changed to tumor have ability for synthesizing melanin. The rarity of this entity and the relevance of magnetic resonance imaging in the accurate and early diagnosis is discussed under the view of the literature. Radiotherapy may be necessary for subtotal resected tumor.

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