Intraosseous schwannoma of the thoracic spine: two case reports and an updated review of the literature

Hangqi Hu¹Dan Cao¹Houyun Xu²Xiping Yu²Xian Wang^1*JI BO HU^1,2*

• ¹Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
• ²The Fourth Affiliated Hospital Zhejiang University School of Medicine, Yiwu, China

Intraosseous schwannomas (IOSs) are benign tumors composed of nerve sheath cells, representing less than 0.2% of primary bone tumors. These tumors most commonly affect the mandible and sacrum, while vertebral involvement remains exceedingly rare. Herein, we present two cases of SISs located at the T2 and T8 vertebrae. We detail the clinical presentation, imaging features, histopathological characteristics, and surgical management of SISs to advance the understanding of this rare condition. Typically presenting as expansile lytic lesions with sclerotic margins, lacking periosteal reaction or calcification, SISs frequently cause foraminal widening and vertebral scalloping, which are characteristic imaging findings that differentiate them from other bone tumors. Complete tumor resection is the recommended treatment, and spinal fusion is often necessary for reconstruction, with recurrence being uncommon after surgery. Additionally, we conduct a review of the existing literature and engage in a discussion regarding this uncommon tumor, enriching clinicians' differential diagnosis of vertebral body osteolytic lesions and providing valuable clinical experience for the individualized selection of surgical approaches.