STUDY DESIGN: A case report of a @entity1 with a gigantic cellular schwannoma in the sacrum treated with high sacral amputation accompanied by careful nerve root-sparing dissection. OBJECTIVES: To describe the atypical clinical course of an intrasacral cellular schwannoma and the surgical procedure of high sacral amputation performed in a way to prevent needless sacrifice of functionally essential nerve roots. SUMMARY OF BACKGROUND DATA: Fundamentally, a cellular schwannoma is a @entity5 , but the clinical course is atypical. The symptoms are mild and the clinicopathologic features often mislead us to make a diagnosis of @entity5 . The occurrence rate of @entity808 was reported to be 0.2% of all @entity5 , and the main location was the retroperitoneal space in the pelvis. Forty-one cases of giant intrasacral @entity808 have been reported so far. Among them, large sacral schwannoma with @entity550 and associated intrapelvic extension was extremely rare. METHODS: The @entity1 presented with a 5-year history of right leg and @entity158 , which did not disturb his daily activities. After a histopathologic diagnosis and a complete set of image studies, high sacral amputation with preservation of uninvolved nerve roots was performed at S1-S2 through a combined anterior and posterior approach. Both S1 nerve roots and the right S2-S3 nerve roots were saved using a threaded saw. The lumbar spine was stabilized to the pelvic girdle using spinal instrumentation with posterolateral fusion. RESULTS: Eighteen months after the @entity5 was resected the @entity1 had a very good clinical outcome, and there were no radiologic signs of instability or recurrence of the @entity5 . Locomotor function of both lower extremities and bowel and urinary functions were well maintained. The @entity1 returned to his previous work. CONCLUSIONS: High sacral amputation following a combined anteroposterior approach provided good results without causing any disability. A detailed preoperative planning and careful dissection of uninvolved nerve roots prevented unnecessary neurologic impairment in locomotion and the detrusor and anorectal function.

XXXX treated with high sacral amputation.

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity808 :: ('MESH:D009442', 'Disease') :: ['intraosseous cellular schwannoma', 'schwannomas'] @entity550 :: ('MESH:D000303', 'Disease') :: ['anterior cortex erosion'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'benign tumor', 'bony tumors', 'malignancy'] @entity158 :: ('MESH:D010146', 'Disease') :: ['buttock pain']
@entity808 :: (MESH:D009442,Disease) :: ['Giant intrasacral cellular schwannoma']
