Introduction: Ancient schwannoma is a rare subtype of spinal schwannomas. It is named for the degenerative changes that it can present. Contrast-enhanced magnetic resonance helps us diagnose, as it can show heterogeneous lesions that capture ring contrast. The treatment is surgical.

Clinical Case: A 67-year-old male patient is presented, with 2 years of the disease characterized by thoracic radicular pain and severe paraparesis in the last 6 months. Contrast-enhanced MRI showed a tumor with heterogeneous uptake, widening the right T2/T3 foramina with right anterior paravertebral extension and severe canal stenosis at the T2 level. A laminectomy plus total resection of the lesion was performed; the pathology study was reported as ancient schwannoma. The evolution was favorable with complete recovery of muscle strength in subsequent months.

Conclusion: Ancient schwannoma is a rare pathology that has peculiar imaging characteristics and whose treatment is surgical.