Laparoscopic resection of a retroperitoneal pelvic schwannoma

Abstract

Schwannomas are rarely located in the pelvis. A 54-year-old woman was found incidentally to have a tumor in the abdomen. Abdominal computed tomography and magnetic resonance imaging revealed a well-defined, heterogeneous tumor, 5 cm in diameter, in the pelvic cavity. With a diagnosis of a mesenteric tumor, a laparoscopic procedure was performed. Intra-operatively, an elastic tumor was identified in the pelvis adjacent to the right internal iliac vein and ureter. The tumor was dissected free from adjacent structures using Liga-Sure and blunt maneuvers. A complete laparoscopic excision was performed. Histopathological examination revealed a benign schwannoma. The patient had an uneventful post-operative course, and was discharged on the fourth post-operative day. Laparoscopic treatment is useful and feasible for retroperitoneal pelvic schwannoma, with minimal invasiveness and an early post-operative recovery. Thus, this procedure may be the first-choice surgical procedure for retroperitoneal pelvic schwannomas.

A giant ancient schwannoma mimicking an adnexal mass

“…The majority of pelvic schwannomas originate from the sacral nerve or the hypogastric plexus. [5] Although schwannomas are generally <5 cm in diameter, those with a retroperitoneal location may reach a much greater size with slow growth over a long period. [2,6] …”

Schwannoma of the seminal vesicle in a patient with rectal cancer

“…CT will identify tumors in the seminal vesicle and shows schwannomas as lesions that are isodense with adjacent muscle possibly with cystic, hemorrhagic, and or calcific internal features [1,3] . Magnetic Resonance Imaging shows schwannomas as hyperintense on T-2 weighted images relative to T-1 images [3,4] . The advantage of using magnetic resonance imaging lies in the enhanced depiction of anatomic relationships.…”

“…The presence of S-100 protein on immunohistochemical staining is also common with Schwann cells. Although malignant change in these tumors is extremely rare, local recurrence is reportedly associated with incomplete excision [3] . Therefore, extra-axial schwannomas should be treated with complete excision whenever possible to minimize the risk of recurrence [7] .…”

Retroperitoneal Schwannoma (Clinical Case)

“…Ретроперитонеальные шван-номы -редкие опухоли, которые составляют приблизительно от 1 до 5% всех ретроперитоне-альных образований [7]. Забрюшинная локали-зация шванном встречается всего в 0,75%-2,6% случаев, чаще они локализуются в конечностях, голове и шее [8,9]. Шванномы, как правило, доброкачественные, солитарные, медленно растущие опухоли, имеющие капсулу.…”