A rare case of schwannoma mimicking ovarian tumour

Abstract

Ovarian tumor is the most common diagnosis in postmenopausal women, presenting with a pelvic mass, though other surgical causes can still be a remote possibility. We report an extremely rare case of a woman, post hysterectomy, presenting with a pelvic mass where both clinical and radiological evaluations were suggestive of an ovarian tumor. The patient underwent laparotomy and a pre-sacral cystic mass was found and excised. Histopathology revealed a schwannoma as the final diagnosis. Hence, it mandates a high index of suspicion to consider other surgical possibilities, vigilant management in the form of advanced radiological evaluation, especially when dealing with doubtful cases of adnexal tumors prior to surgery.

Schwannoma mimicking ovarian malignancy

“…Schwannomas are generally benign tumors originating from the Schwann cells that form the myelin sheath around the peripheral nerve [3] . Schwannomas in the retroperitoneal space are rare and mainly located in the pelvis, usually in the paravertebral and presacral region [4] . They are prevalent between 40 and 60 years of age and in female patients [4] .…”

“…Schwannomas in the retroperitoneal space are rare and mainly located in the pelvis, usually in the paravertebral and presacral region [4] . They are prevalent between 40 and 60 years of age and in female patients [4] .…”

“…As they are slow-growing tumors, they usually present as solitary and asymptomatic masses [3 , 4] . When symptomatic, they usually present with compressive symptoms due to the size of the tumor.…”

“…Neurological symptoms, including pain and paresthesia, have also been reported. Urinary and gastrointestinal symptoms caused by the compression of the urinary bladder and intestine may also occur [3 , 4] . Calcification is observed in 23% of cases and cystic degeneration in almost 60% of cases [3 , 4] .…”

“…Preoperative diagnosis of pelvic schwannomas is extremely challenging due to their non-specific imaging characteristics [4] . It is an encapsulated well-defined nerve tumor.…”