Posterior fossa melanocytic schwannoma extending to the cervicothoracic spinal cord: A clinical rarity.

BACKGROUND

Melanocytic schwannomas (MSs) are rare, malignant peripheral nerve sheath tumors with only 200 cases reported to date. These pose imaging and pathological challenges for definitive diagnosis.

CASE DESCRIPTION: A 25-year-old lady presented at our center with a prolonged history of gait disturbance, left ear tinnitus, headaches, and drowsiness. MRI findings showed a midline cystic lesion in the posterior cranial fossa extending caudally to the D1 vertebral body, with marked central hypointensity, and peripheral hyperintensity on T1-weighted images. A suboccipital craniotomy and debulking of the lesion were performed, showing a hyperpigmented, infiltrative tumor adherent to the surrounding structures. This was confirmed as a melanocytic schwannoma on histopathological analysis.

CONCLUSION

Posterior fossa MSs involving cervicomedullary region and extending distally to cervicothoracic spinal cord are rare and complex cases, particularly with regard to difficulty diagnosing preoperatively and surgical resection.