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Federación Mexicana de Ginecología y Obstetricia, A.C.

2018, Number 03

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Ginecol Obstet Mex 2018; 86 (03)

Pelvic retroperitoneal schwannoma presenting as a leiomyoma: Case report and review of literature

López-Ruiz CC, de los Ríos-Posada JF, Cifuentes-Pardo C, Bernal J, Echeverri-Tabares N

Language: Spanish
References: 21
Page: 217-223
PDF size: 679.37 Kb.


ABSTRACT

Objective: Present the case of a patient with a pelvic mass which was reported as myoma and turned out to be a schwannoma.
Clinical case: We report a case of a 53 year old female that presented with abdominal and low back pain, also distention, constipation and dyspareunia for 3 months. Transvaginal ultrasound suggested leiomyoma. Laparoscopic hysterectomy was planned. On laparoscopy, a retroperitoneal 9 cm mass was seen over de sacrum. The procedure was stopped for further studies. Magnetic resonance images detected a large presacral solid, tumor of 8 cm. The patient was scheduled for laparoscopy with oncology group and the mass was resected. No complications were experienced intra or postoperatively. The final histological diagnosis was a cellular schwannoma, that was S-100- positive, and smooth muscle actin-negative. A follow up consultation 6 months later showed a significant improvement of the lower abdominal pain.
Conclusions: Schwannomas rarely present as pelvic masses. We report a woman with a pelvic mass initially diagnosed as a uterine fibroid but subsequently proven to be a retroperitoneal schwannoma. This rare entity is usually asymptomatic or has nonspecific symptoms leading to misdiagnosis. Preoperative diagnosis of a schwannoma is not easy for a lack of distinguishing features on imaging studies. The prognosis of schwannoma is excellent, and the excision is usually curative.


REFERENCES

  1. Kransdorf MJ, Murphey MD. Neurogenic tumors. In: Kransdorf MJ, Murphey MD, and editors. Imaging of Soft Tissue Tumors. Philadelphia: Saunders, 1997;241-254.

  2. De Diego E, Roca A, Martín B. Schwannoma benigno retroperitoneal: aportación de un nuevo caso. Actas Urol Esp. 2000;24:685-8.

  3. Ogose A, Hotta T, Sato S, Tkano R, Higuchi T. Presacral schwannoma with purely cystic form. Spine. 2001;15:1817– 1819.

  4. Li Q, Gao C, Juzi JT, Hao X. Analysis of 82 cases of retroperitoneal schwannoma. Aust N Z J Surg. 2007;77:237–240.

  5. Daneshmand S, Youssefzadeh D, Chamie K, et al. Benign retroperito-neal schwannoma: a case series and review of literature. Urology. 2003;62:993–997.

  6. White W, Shiu MH, Rosenblum MK, et al. Cellular schwannoma: a clinicopathologic study of 57 patients and 58 tumors. Cancer. 1990; 66:1266 –1275.

  7. Padmanaban N, priya subash chandrabose, muthuvel esakki, hephzibah kirubamani, chitra srinivasan Gynaecological Perspective of Schwannoma: A Rare Pelvic Tumour. Journal of Clinical and Diagnostic Research. 2016 Apr, Vol-10(4).

  8. Zimmerman RA, Bilaniuk LT. Imaging of tumors of the spinal canal and cord. Radiol Clin North Am. 1988;26:965-1007.

  9. Giglio M, Giasotto V, Medica M, et al. Retroperitoneal ancient schwannoma: case report and analysis of clinicoradiological findings. Ann Urol. 2002;30:104-106.

  10. Possover M, Forman A. Voiding dysfunction associated with pudendal nerve entrapment. Curr Bladder Dysfunc Rep. 2012;7:281-285.

  11. Domínguez JR, Lobato A, Rqamos J, Rivas P, et al. Giant intrasacral schwannomas: report of six cases. Acta Neurochir. 1997; 139:954-960.

  12. Rengachary SS, O’Boynick P, Batnitzky S, Kepes JJ. Giant intrasacral schwannoma: case report. Neurosurgery. 1981;9:573-577.

  13. Ortolan EG, Sola CA, Gruenberg MF, Vazquez FC. Giant sacral schwannoma: a case report. Spine. 1996;21:522-526.

  14. Abernathey CD, Onofrio BM, Scheithauer B, Pairolero PC, Shives TC. Surgical management of giant sacral schwannomas. J Neurosurg. 1986; 65:286-295.

  15. Tang X, Guo W, Yang R, et al. Risk factors for blood loss during sacral tumor resection. Clin Orthop Relat Res. 2009;467:1599-1604.

  16. Hoarau N, Slim K, Da Ines D. CT and MR imaging of retroperitoneal schwannoma. Diagnostic and Interventional Imaging. DOI: 10.1016/j.diii.2013.06.002

  17. Dawley B. A retroperitoneal femoral nerve schwannoma as a cause of chronic pelvic pain. J Minim Invasive Gynecol. 2008;15:491-493.

  18. Sinha R, Sundaram M, Hedge A, Mahajan C. Pelvic schwannoma masquerading as broad ligament myoma. J Minim Invasive Gynecol. 2008;15:217-219.

  19. Nishio A, Adachi W, Igarashi J, Kolde N, Kajikawa S, Amano J. Laparoscopic resection of a retroperitoneal schwannoma. Surg Laparosc Endosc Percutan Tech. 1999;9:306-309.

  20. Asakage N. Laparoscopic resection of a retroperitoneal schwannoma. Asian J Endosc Surg 2012;5(1):25-30.

  21. Possover M, Plamen K. Laparoscopic management of sacral nerve root schwannoma with intractable vulvococcygodynia: Report of three cases and review of literature. DOI: https://doi.org/10.1016/j.jmig.2012.12.011




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