J Neurosurg Spine 42:650–658, 2025
The review discusses cervical schwannomas, focusing on their pathophysiology, clinical presentation, and management strategies, including surgical resection and stereotactic body radiation therapy (SBRT). It emphasizes the importance of a multidisciplinary approach for optimal patient outcomes and highlights the need for ongoing research.
• Cervical schwannomas are benign tumors originating from Schwann cells, often occurring in the intradural, extramedullary space of the cervical spine.
• MRI is the primary imaging modality for diagnosing schwannomas, characterized by avid Gd uptake and specific radiographic features.
• Surgical resection is the main treatment approach, with gross-total resection preferred to minimize recurrence. Various surgical techniques are available depending on tumor location.
• Stereotactic body radiation therapy (SBRT) is a viable alternative for patients who are not surgical candidates, offering good local control and symptomatic relief.
• Histological analysis distinguishes schwannomas through specific features such as Antoni A and B areas and Verocay bodies. Immunohistochemical stains like S100 and SOX10 aid in diagnosis.
• Multidisciplinary management is crucial, integrating surgical and nonsurgical options to optimize patient outcomes and quality of life.
• Observation may be suitable for asymptomatic patients with slow-growing lesions, with regular monitoring to assess progression.
• Malignant transformation into peripheral nerve sheath tumors is rare but possible, particularly in patients with NF1.
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