Atypical Presentation of a Retrorectal Ancient Schwannoma: A Case Report and Review of the Literature

Abstract

Retrorectal tumors are rare and frequently present either incidentally or with vague symptoms. Schwannomas of the presacral region are one variant described as benign tumors of neurogenic origin. The "ancient degenerative variant" is uncommonly reported. We present the case of a 37-year-old man presenting with symptoms of left renal colic, impotence, and left trochanteric pain. Computed tomography and magnetic resonance imaging of the pelvis showed a presacral mass with cystic changes and calcifications consistent with a schwannoma. The patient underwent an exploratory laparotomy with resection of the tumor, which subsequent analysis showed to be a schwannoma with ancient degenerative changes.

Neurological Outcome Following Resection of Benign Presacral Neurogenic Tumors Using a Nerve-Sparing Technique

“…the data available consist mainly of small case series (between 1 and 13 cases), 7,8,10,11 or larger series of mixed presacral tumors, of which neurogenic tumors constituted only a small proportion of these cases (between 3 and 11 cases in series of 27-120 patients). the data available consist mainly of small case series (between 1 and 13 cases), 7,8,10,11 or larger series of mixed presacral tumors, of which neurogenic tumors constituted only a small proportion of these cases (between 3 and 11 cases in series of 27-120 patients).…”

Retrorectal Schwannomas: Atypical Presentation and Controversial Surgical Management

“…Retrorectal schwannomas are extremely rare as they represent only 1 to 5% of all schwannomas [ 3 ]. These tumors are found most commonly in the head, neck, and extremities, while only 0.5–5% occur in the retrorectal space [ 4 ], representing 1 in 250 of all retrorectal tumors [ 5 ]. They can be asymptomatic and incidentally revealed by a pelvic or a rectal examination; however, they can be revealed by pelvic pain, back pain, lower extremities pain, or constipation [ 3 , 5 ].…”

“…A biopsy of such a lesion is controversial but if done it can differentiate between benign and malignant tumors [ 6 ]. The treatment of choice is local monoblock resection of the mass [ 5 ]. Hereby, we report a case of a male adult consulting for chronic low back pain who was eventually diagnosed with retrorectal schwannoma.…”

Single Stage Posterior Approach for Total Resection of Presacral Giant Schwannoma: A Technical Case Report

“…Tumors in the presacral space are uncommon. Presacral neurogenic tumors are even rarer with 10%–15% of the presacral region tumors 15) . The neurogenic tumor of frequent occurrence in the presacral area is the schwannoma 13) .…”