TY - JOUR T1 - One-Stage Resection of Giant Invasive Thoracic Schwannoma: Case Report and Review of Literature JF - Ochsner Journal JO - Ochsner J SP - 135 LP - 140 VL - 14 IS - 1 AU - Edison P. Valle-Giler AU - Juanita Garces AU - Roger D. Smith AU - Wale A. R. Sulaiman Y1 - 2014/03/20 UR - http://www.ochsnerjournal.org/content/14/1/135.abstract N2 - Background Schwannomas comprise approximately 25% of all spinal tumors, being the third most frequent soft-tissue tumor after hemangiomas and lipomas. Grade 5 invasive giant schwannomas erode the vertebral bodies, involve 2 or more levels, and invade the myofascial planes. Because 3 compartments are involved, these tumors represent a surgical challenge and frequently require staged surgeries with a multidisciplinary surgical team.Case Report We report the case of a 62-year-old female who presented with intermittent upper back pain for 3 years. A magnetic resonance imaging scan of the thoracic spine showed a mass invading the vertebral body, pedicle, and lamina of T4 and part of T3 and T5. Needle biopsy confirmed the diagnosis of schwannoma. The patient underwent surgery using a parascapular extracavitary costotransversectomy approach.Conclusion Giant invasive spinal schwannomas are rare in the thoracic spine, and surgical approaches usually have entailed multiple-stage surgeries with the assistance of other surgical specialties. Our 1-stage complete surgical resection of a giant invasive spinal schwannoma used a parascapular costotransversectomy approach that maintained spinal stability and thus avoided the need for instrumentation. ER -