Serendipitous Discovery of a Benign Obturator Nerve Schwannoma

Sumalatha, Suhani; Appala, Nikhila; Shetty, Ashwija; Nayak, Deepak Ranjan; Prabhath, Sushma; Bhat, Nandini

doi:10.18295/squmj.4.2021.016

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…However, they can undergo malignant transformation when associated with Von Recklinghausen disease (type II neurofibromatosis) or when an epithelioid morphology of peripheral nerve sheath tumor is present [ 4 , 11 ]. They are usually large at the time of diagnosis, because they are asymptomatic or have vague symptoms, such as abdominal pain [ 3 , 4 ], and rarely neurological manifestations, such as limb pain, paresthesia, and motor weakness due to the compression of adjacent structures [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

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Robotic-Assisted Resection of a Benign Schwannoma of the Obturator Nerve: A Rare Case

Bulisani,

Ströher,

Rossi

et al. 2024

Am J Case Rep

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Patient: Female, 51-year-old Final Diagnosis: Benign retroperitoneal schwannoma (neurilemoma) of the obturator nerve Symptoms: Left pelvic discomfort complaint for 3 months Clinical Procedure: — Specialty: Surgery Objective: Rare disease Background: Neurilemmomas are rare tumors derived from the Schwann cells that comprise the peripheral nerve sheaths. They have a slow growth and rarely display malignancy. Early diagnosis is rare, and the treatment consists by surgical resection. Although robotic-assisted surgery is commonly used for treating retroperitoneal diseases, there are few reports of resection of retroperitoneal and pelvic schwannoma through robotic-assisted surgery. In the present study, we reported a case of complete excision of a benign retroperitoneal schwannoma of the obturator nerve by robotic-assisted surgery. Case Report: A 51-year-old woman was referred by her gynecologist for left pelvic discomfort of a 3-month duration. The physical examination was normal, but a computerized tomography scan of the abdomen and pelvis showed an expansive pelvic lesion in the topography of the left iliac vessels, a hypodense contrast enhancement measuring 4.6×3.4 cm. Magnetic resonance imaging showed an extraperitoneal lesion located medially and inferi-orly to the left external iliac vessels, with a size of 4.9×3.7 cm, and of probable neural etiology. Surgical resection of the tumor was recommended because of the diagnostic hypothesis of obturator nerve schwannoma. Conclusions: This case showed that retroperitoneal neurilemmomas are difficult to diagnose owing to a lack of specific symptoms, and the best treatment is complete tumor resection. The use of robotic techniques gives greater dexterity to the surgeon, since it provides high-definition 3-dimensional vision, which can make the removal of retroperitoneal tumors susceptible to minimally invasive resection in a safe and effective way.

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Section: Discussionmentioning

confidence: 99%

“…The obturator nerve comes from the ventral branch of the second, third, and fourth lumbar nerves [ 12 ]. It supplies the external obturator muscle, adductor thigh muscle, and hip and knee joints and is responsible for the sensory innervation of the medial thigh [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Robotic-Assisted Resection of a Benign Schwannoma of the Obturator Nerve: A Rare Case

Bulisani,

Ströher,

Rossi

et al. 2024

Am J Case Rep

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“…However, occurrence in the pelvis is rare. Diagnostic methods for schwannomas typically involve the use of computed tomography (CT) or magnetic resonance imaging (MRI) [1][2][3][4]. However, in cases where schwannomas arise outside the head and neck region and are complicated by malignant tumors, distinguishing them from lymph node metastasis can pose diagnostic challenges.…”

Section: Introductionmentioning

confidence: 99%

Presacral Schwannoma Resembling Lymph Node Metastasis in a Patient with Locally Advanced Prostate Cancer

Hama,

Tate

2024

Indonesian Journal of Cancer

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Introduction: SSchwannomas originating in the pelvic region are rare and present diagnostic challenges when they coexist with malignancies. Case Presentation: A 58-year-old man with urinary frequency and an elevated prostate-specific antigen level underwent preoperative imaging. T2-weighted magnetic resonance imaging (MRI) of the prostate identified an irregular hypointense lesion with extracapsular invasion, as well as a presacral nodule resembling lymph node metastasis. The presacral nodule exhibited an intermediate signal intensity on the apparent diffusion coefficient map that was derived from diffusion-weighted images. Dynamic contrast-enhanced MRI revealed persistent enhancement in the presacral node, while the prostate tumor exhibited strong early enhancement followed by washout. Pathological and laparoscopic findings confirmed the coexistence of locally advanced prostate cancer and pelvic schwannoma. Conclusions: MRI is useful not only in detecting prostate cancer but also in differentiating lymph node metastases from schwannoma.

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Obturator nerve schwannoma: a case report and review of the robotic literature

Bayne,

Vuong,

Bal

et al. 2024

Journal of Surgical Case Reports

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Obturator schwannomas are rare and often misdiagnosed as intraperitoneal pelvic masses. The optimal surgical approach for their resection is unclear. This study presents a case demonstrating the safe use of robotics for resecting a benign pelvic schwannoma and reviews the literature on robotic cases. Here, a 40-year-old woman with right lower quadrant pain underwent imaging, revealing a 4.6 × 3.3 × 3.6 cm pelvic mass. She had a robotic-assisted laparoscopic excision, with pathology confirming a benign schwannoma. Complete tumor resection is the gold standard. The use of minimally invasive robotic-assisted surgery is increasing due to improved visualization, efficient movement, and safety, making it a viable option for resecting obturator schwannomas.

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Serendipitous Discovery of a Benign Obturator Nerve Schwannoma

Cited by 4 publications

References 20 publications

Robotic-Assisted Resection of a Benign Schwannoma of the Obturator Nerve: A Rare Case

Robotic-Assisted Resection of a Benign Schwannoma of the Obturator Nerve: A Rare Case

Presacral Schwannoma Resembling Lymph Node Metastasis in a Patient with Locally Advanced Prostate Cancer

Obturator nerve schwannoma: a case report and review of the robotic literature

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