Giant sacral schwannoma excised under intraoperative neuromonitoring in an elderly patient: case report

Abstract

Schwannomas are mainly benign tumors arising from the Schwann cells of the peripheral nerve sheath. These tumors can often be associated with non-specific symptoms, such as abdominal heaviness. In this article, we present a detailed description of the surgical management of a giant sacral schwannoma in an elderly patient, for which intraoperative neuromonitoring made it possible to distinguish easily the nerves of the sacral plexus from which the tumor originated and to remove it without complications. Treatment of these rare and symptomatic giant tumors is still a challenge for surgeons; to treat adequately these tumors; a multidisciplinary approach is required to ensure an optimal therapeutic approach to reduce the risk of recurrence and, on the other hand, is not associated with unnecessary iatrogenic neurological damage.

Rare retroperitoneal giant sacral schwannoma: A case report

“…Using curettage and radiotherapy approaches for giant sacral schwannomas in 4 patients maximally protect the sacral nerve bundle in a study by Chandhanayingyong et al (39); however, the recurrence rate was 54%. Some scholars have proposed that nerve monitoring should be performed during the removal of giant sacral schwannomas to achieve maximal tumor resection while avoiding nerve injury and reducing tumor recurrence (19,40). The diagnosis must be reliable before surgical treatment for giant sacral schwannoma, avoiding the intralesional resection of retroperitoneal malignancies (41).…”