Objective: The purpose of this case report was to describe a patient presenting with back pain subsequently diagnosed with thoracic schwannoma.
Clinical Features: A 45-year-old male presented to a chiropractic practice with mid-back, low back, and sacroiliac pain. Orthopedic examination revealed joint dysfunction in the thoracic–sacroiliac region with normal findings on neurologic examination. An initial diagnosis of thoracic spinal pain and sacroiliac sprain and strain was made. At approximately 7 weeks of treatment, because of the patient’s persistent pain, chest magnetic resonance imaging (MRI) was ordered by the chiropractic physician.
Interventions and Outcomes: The chest MRI revealed an intradural extramedullary mass at the T5 level creating a marked compression of the spinal cord. A thoracic MRI was conducted 2 days later confirming the presence of the tumor. The patient was successfully treated with spinal surgery to remove a schwannoma.
Conclusions: Mechanical spinal pain is a common symptom in patients presenting to chiropractic offices and may present concurrent with other pathology. In the presence of unresolved persistent thoracic pain, clinicians should investigate other potential causes.
Author Keywords: Neurofibroma; Tumors; Spinal Cord
Author affiliations: Fort Lee Chiropractic Associates; (United States / New Jersey / Fort Lee); Private Practice (United States / California / San Diego)
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