LAUSR

BACKGROUND Sacral schwannomas are very rare nerve sheath tumors. Patients usually present with a variety of non-specific symptoms, which often lead to a delay in diagnosis. Although, most schwannomas are benign, they present surgical challenges due to their proximity to neurological and other anatomical structures. CASE PRESENTATION Patient is 58-year-old female that presented with a 2-month old history of left-sided perineal and radicular pain secondary to a right S2 sacral nerve root schwannoma. The sacral mass demonstrated homogenous enhancement with cystic changes in T2-weighted MRI sequence. Patient underwent S1 to S3 laminectomies and tumor excision through a posterior surgical approach. Intraoperative monitoring was used to distinguish non-functional tissue during tumor resection. Patient had an unremarkable postoperative course. CONCLUSION Sacral schwannomas can present with a variety of non-specific symptoms. They present unique challenges given their location, size, and involvement of surrounding structures. Complete surgical resection is the main goal of treatment of sacral schwannomas. Combined anterior-posterior surgical approaches and multi-disciplinary surgical teams improve outcomes.