Thoracic dumbbell intra- and extramedullary schwannoma.

We present a rare case of a solitary dumbbell intra- and extramedullary schwannoma of the thoracic spine in a 54-year-old man without signs of von Recklinghausen's disease. The patient presented with motor weakness in the left lower extremity, bilateral sensory impairment below the T9 dermatome and rectovesical dysfunction. Preoperative magnetic resonance imaging was suspicious for an intradural extramedullary tumor.

Repeat operations in the management of clival chordomas: palliative surgery.

Some chordomas have a very poor prognosis because of their aggressive growth nature, but the efficacy of repeat operations for these cases has not been well documented. This report concerns 3 patients with aggressive chordoma of the clivus, who underwent operations 6 to 12 times over a period of 8 to 17 years because of symptomatic regrowth. Overall mean interval between repeat operations was 18 months with a range from 5 to 57 months and survival times were 9 to19 years after the first surgery.