PMC7749958_01
Preoperative non-contrast CT (top) and MR (bottom) sagittal, axial, and coronal images demonstrating a large presacral schwannoma (white arrow) extending from the left S1 neuroforamen. Axial MR image demonstrates close proximity of iliac vessels (short blue arrow).
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F1
S1 foraminal schwannoma. She had developed progressive symptoms (e.g., left S1 distribution: pain, plantar flexor weakness, and sensory loss) with the evidence of increased growth into the presacral space on enhanced MR studies (e.g., 2.2 x 3.0 x 5.0 cm) [Figure 1].
Intraoperative photomicrograph of the surgical field during posterior resection of a presacral schwannoma demonstrating the tumor, S1 nerve root, S1 foramen, and tumor capsule.
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F2
The tumor capsule was then incised, and tumor was debulked, and dissected away from the surrounding structures [Figure 2].
Postoperative sagittal and coronal non-contrast MR images demonstrating total resection of the pre-sacral schwannoma as well as postoperative changes. White arrow points to resection cavity.
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F3
Postoperative imaging demonstrated gross total resection of the tumor, and she was discharged home uneventfully after a short hospital stay [Figure 3].