Abdominal Wall Schwannoma

Abstract

Neurilemmomas-or schwannomas-are rare soft tissue tumours involving peripheral nerve sheaths, usually found in the head and neck regions. They can infrequently originate within the tissues of the abdominal wall. Here, we present a case of symptomatic schwannoma of the abdominal wall in a 62-year-old woman referred for abdominal pain in the right iliac fossa. On physical examination, a 5-7-cm oval-shaped area of consolidation with regular borders and elastic consistence was palpable. Ultrasound examination of the abdomen revealed a hypoechogenic mass measuring 80-33-42 mm; subsequently, a CT scan confirmed the presence of a well-circumscribed mass, with small calcifications inside. Radical excision of the lesion under general anaesthesia was performed, and the histological examination was consistent with the diagnosis of "ancient" schwannoma. The patient was discharged on the second postoperative day, and, at a clinical check 1 month postoperation, she reported no recurrence of abdominal pain and had an improved quality of life. Schwannomas have a good prognosis overall, with malignant degeneration being very rare. Local recurrence is plausible only if non-radical resection of the primitive tumour occurs. This is the second case ever reported, to our knowledge, of symptomatic schwannoma of the abdominal wall. We advocate surgical removal of the tumour when it presents as a cause of abdominal pain, ensuring that a radical excision is performed due to the possibility-though rare-of malignant transformation or recurrence. This offers the possibility of total regression of symptoms through surgical therapy.

External Oblique Muscle Schwannoma: A Rare Anatomical Presentation

“…Schwannomas are usually solitary lesions, and they have a predilection for the trunk, head, neck, and flexures or surfaces of the limbs [1–3]. They have rarely been reported on the abdominal wall [5–7].…”

“…To the best of our knowledge, only five cases of benign schwannoma located in the abdominal wall have been reported in the medical literature at present [3–7]. In the first case [4], a healthy 64-year-old female underwent a whole body CT scan, which revealed an incidental mass in the right iliac fossa.…”

“…Followingly, abdominal computed tomography (CT) scan revealed a 17 × 11 mm mass in her abdominal wall. In the fourth case [7], a 62-year-old woman was admitted for the evaluation of a painful mass in her right iliac fossa. The fifth case [3] reported the case of a 70-year-old man presented with a painless nodule localized in his left abdominal wall.…”

“…Their presentation in the abdominal wall is extremely rare, and to the best of our knowledge, this is the sixth reported case of an abdominal wall benign schwannoma [3–7]. In addition, this is the fourth symptomatic case [3, 6, 7].…”

Nonfunctional paraganglioma of the head of the pancreas: A rare case report

“…The gross appearance of paragangliomas is that of a richly vascularized mass, growing typically near to large blood vessels or nerves. Nevertheless, from a histological point of view, differential diagnoses with meningiomas, schwannomas, hemangiopericytomas, melanomas, and various metastatic carcinomas may be challenging [4] . Fortunately, immunohistochemical positivity for neurospecific enholase (NSE), synaptophysin, chromogranin, and no staining for cytokeratins, is diagnostic of paragangliomas [5] .…”