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Proposed mechanism of epi-pial adhesion in a peripheral spinal schwannoma. (a) The tumor likely originated immediately distal to the pial entry site of the proximal sensory root; here, focal adhesions between the perineurium (sensory root sheath) and the pia mater probably developed. (b) Progressive tumor growth resulted in broad-based adhesions along the perineurium–pia interface. There was no intramedullary tumor extension. PSA: Posterior spinal artery.
