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CASE REPORT article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1544175
Lateral Retroperitoneal Approach for the Treatment of a Recumbent Silkworm-like Paravertebral Schwannoma in the Lumbar Spine: A Case Report
Provisionally accepted- 1 Shandong Provincial Qianfoshan Hospital, Jinan, China
- 2 Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong Province, China
- 3 Shandong Second Medical University, Weifang, Shandong Province, China
OBJECTIVE: This case report describes the surgical management of a recumbent silkworm-like paravertebral schwannoma in the lumbar spine resected via the lateral retroperitoneal approach.METHODS: A lumbar paravertebral schwannoma resembling a "recumbent silkworm” was excised using the lateral retroperitoneal approach. Intraoperative measures included electrophysiological monitoring and insertion of a ureteral D-J stent to protect critical surrounding anatomical structures. Complete tumor resection was achieved without intraoperative complications. Follow-up demonstrated no tumor recurrence or postoperative complications.RESULTS: The duration of surgery was 310 min, with an estimated blood loss of 50mL. The tumor resection rate was 100%. The patient was discharged 11 days after hospitalization. Postoperative histopathological examination confirmed the diagnosis of schwannoma. There were no postoperative complications. The patient ADL (Activities of Daily Living score did not decline compared with the preoperative levels. After one year of follow-up, no signs of tumor recurrence were observed.CONCLUSION: Paravertebral tumors located in the anterior and lateral aspects of the lumbar spine pose significant surgical challenges because of their complex position and morphology. Complete excision of such tumors via the lateral retroperitoneal approach is an optimal treatment strategy.KEYWORDS: lateral retroperitoneal approach， recumbent silkworm-like, schwannoma, lumbar, anterolateral retroperitoneal approach
Keywords: Lateral retroperitoneal approach, recumbent silkworm-like, Schwannoma, Lumbar, anterolateral retroperitoneal approach
Received: 12 Dec 2024; Accepted: 27 Feb 2025.
Copyright: © 2025 Su, Liu, Li, Liu, Zhang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Lanming Su, Shandong Provincial Qianfoshan Hospital, Jinan, China
Feng Li, Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong Province, China
Yuanqin Liu, Department of Neurosurgery, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Jinan, 250014, Shandong Province, China
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