PT - JOURNAL ARTICLE AU - Algahtany, Mubarak A. AU - Almalki, Ahmad M. AU - Albeshre, Ismaeel D. AU - Badri, Rabab N. TI - Unique challenges in the management of a Giant retroperitoneal Schwannoma associated with vertebral body destruction and spinal canal invasion AID - 10.17712/nsj.2021.3.20200184 DP - 2021 Jul 01 TA - Neurosciences Journal PG - 289--294 VI - 26 IP - 3 4099 - http://nsj.org.sa/content/26/3/289.short 4100 - http://nsj.org.sa/content/26/3/289.full SO - Neurosciences (Riyadh)2021 Jul 01; 26 AB - Retroperitoneal schwannomas are rare, and giant lesions associated with osteolysis are unique clinical entities for which management guidelines are lacking. Herein, we present our experience with treating a large paraspinal retroperitoneal schwannoma, compare it with previously reported cases, highlight the challenges faced with its management, and propose a treatment plan. A 56-year-old female patient presented with back and left leg radicular pains. Contrast-enhanced CT and MRI scanning and histological analysis confirmed the presence of a giant retroperitoneal schwannoma causing near-complete destruction of the fourth lumbar vertebral body and spinal canal invasion. The tumor was totally removed by a two-step operation with no adverse consequences. The patient recovered well and remained in good clinical and radiological status 9 months post-surgery. Therefore, retroperitoneal schwannomas causing bone destruction and spinal canal invasion are best treated through a combined posterior-anterior approach.