Intercostal Nerve Schwannoma As a Rare Cause of Refractory Mid Back Pain

Document Type : Case Report

Authors

1 Consultant, Department of Orthopedic surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

2 Consultant, Neurosurgery, Ibn Sina Diagnostic and Consultation Center, Lalbag, Dhaka, Bangladesh

3 Assistant Registrar, Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh

4 Neurosurgery Unit, Highly Specialized Hospital and National Importance, Garibaldi, Catania, Italy

5 Department of Neurological Surgery, Christian Doppler Medical Centre, Laboratory for Microsurgical Neuroanatomy, Paracelsus Medical University, Salzburg, Austria

6 Division of Anesthesia, Sardar Women Hospital, Bapunagar, Ahmedabad, India

7 Department of Neurosurgery, Trauma and Gamma Knief Centre, Cannizzaro Hospital, Catania, Italy

8 Consultant, Department of Neurosurgery, Bhawani Hospital and Research Centre, Birgunj, Nepal

10.21608/ijma.2021.71247.1294

Abstract

Background: Schwannoma is the most common neurogenic tumor of the posterior mediastinum. Though commonly become asymptomatic, back pain with intercostal neuralgia mimicking post herpetic neuralgia is rare presentation and infrequently found in the available literature 
Case description: Here, we report a 22-year-old female without any history of trauma, surgery or infection presented with midback pain with radiation towards the right 10th intercostal space. Although clinical evaluation simulates the features of post herpetic neuralgia, she was mildly responsive to traditional conservative treatment. Later on, magnetic resonance imaging [MRI] was performed to rule out the neoplastic cause which ultimately revealed Schwannoma of the right 10th intercostal nerve. Patient symptomatically get well after complete removal of tumor.  Beside this, we also briefly review the clinical presentation, neuroimaging features, different surgical options and outcome from the pertinent literature.
Conclusion: This report emphasizes early radiological evaluation of dull aching resting pain to avoid unnecessary medications to prolong duration.

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