Intraoperative Ultrasound and Contrast-Enhanced Ultrasound (CEUS) Features in a Case of Intradural Extramedullary Dorsal Schwannoma Mimicking an Intramedullary Lesion.

Introduction ▼ Primary spinal tumors are relatively rare lesions, representing 4–8 % of all central nervous system tumors (Duong LM et al. Cancer 2012; 118: 4220–4227). Magnetic resonance imaging (MRI) represents the gold standard for the diagnosis and assessment of intradural tumors. Nevertheless, sometimes MRI may not accurately differentiate between intramedullary and extramedullary tumors. The role of intraoperative ultrasound (ioUS) on the other hand is not yet well-defined and standardized for this surgical field. We report a case of a dorsal schwannoma in which preoperative MRI showed findings compatible with an intramedullary lesion with an exophitic component. However, ioUS with the adjunct of contrast-enhanced ultrasound (CEUS) helped to reveal the lesion to be completely extramedullary. To the best of our knowledge, this is the first reported case of use of CEUS during spinal tumor surgery.