PMC10276332_01
PMC10276332_02
A) a heterogenous contrast-enhancing mass (indicated within red circle) from the L5 nerve root extending to retroperitoneal space and eroding some of the L5 vertebral body; B) the mass (indicated within red circle) originated from L5 nerve root extending to retroperitoneal space with craniocaudal length >2 vertebral bodies
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F1
The MRI with contrast showed the presence of an extradural soft tissue tumor, measuring 8.6x7.4x9.7 cm, compressing the L5-S1 intervertebral foramen and extending into the retroperitoneal space, as well as compressing the right iliac artery, as shown in Figure 1.
A) preoperative photo showing incision marking and preparation for retroperitoneal approach; B) intraoperative photo showing a white-greyish mass with well-defined edges was found in retroperitoneal space (indicated by a white arrow)
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F2
The L5 vertebral body and disc space were identified with C-arm fluoroscopy and then marked on the patient's skin, as shown in Figure 2A. After identifying the peritoneum, blunt dissection was performed down to the retroperitoneal space using a sponge stick, as shown in Figure 2B.
A) microscopic examination showing hypercellular (antoni A) and hypocellular area (Antoni B) (haematoxylin and eosin stain, original magnification x100); B) microscopic examination showing cells are narrow and elongated, nuclear palisading around the fibrillary process (verocay bodies) (haematoxylin and eosin stain, original magnification x400)
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F3
The results followed the characteristics of a benign schwannoma tumor, as depicted in Figure 3.