Benign schwannoma of the obturator nerve: A case report

Scotto, V.; Romanucci, Giovanna; Valeri, Barbara; Limiti, M. R.; Corti, Enrico

doi:10.1016/s0002-9378(98)70090-0

Cited by 11 publications

(15 citation statements)

References 2 publications

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“…Furthermore, obturator nerve schwannomas are extremely rare, and none of them has been diagnosed correctly preoperatively (). It is thought that the reason for this is the lack of typical imaging findings.…”

Section: Discussionmentioning

confidence: 99%

“…If malignancy is suspected, the tumor should be resected completely with surrounding tissues, including the obturator nerve. Such complete resection has been performed in some cases (), but the neurological disorders that occur postoperatively are permanent. Injury to the obturator nerve results in variable gait disturbance, weakness of thigh adduction, and inconstant sensory loss over the medial thigh ().…”

Section: Discussionmentioning

confidence: 99%

“…Only 1%–3% of schwannomas have been reported to occur in the pelvis (). Furthermore, obturator nerve schwannomas are extremely rare, with only nine cases having been reported in the English‐language literature ().…”

Section: Introductionmentioning

confidence: 99%

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Laparoscopically resected obturator nerve schwannoma: A case report

Takahashi

Hara

Tsuboi

et al. 2016

Asian J Endoscop Surgery

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Obturator nerve schwannomas are very rare. To date, only nine cases have been reported in the English-language literature; none of these were diagnosed preoperatively. A 68-year-old woman was admitted with left lower abdominal pain. CT and MRI revealed a mass 30 mm in diameter in the left obturator fossa, suggesting a retroperitoneal tumor. Because CT and MRI revealed clear continuity with the left obturator nerve, this case was diagnosed as an obturator nerve schwannoma. Tumor enucleation was performed by laparoscopy. On histopathological examination, this case was diagnosed as a benign obturator nerve schwannoma. Postoperatively, the patient developed weakness of the adductor muscle but recovered within 6 months with rehabilitation therapy. Preoperative diagnosis of obturator nerve schwannomas is quite difficult, but careful inspection of CT and MRI is important to identify the original nerve of schwannoma preoperatively. Accordingly, laparoscopic resection is a good treatment option.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laparoscopically resected obturator nerve schwannoma: A case report

Takahashi

Hara

Tsuboi

et al. 2016

Asian J Endoscop Surgery

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mentioning

confidence: 99%

“…The tumours tend to be slow growing and may be asymptomatic, or alternatively may present with pain or paraesthesia in the distribution of the nerve of origin. Schwannoma of the obturator nerve is a rare occurrence, and although several cases have been reported in the literature, [2][3][4][5] to the best of our knowledge, this is the largest tumour described. Preoperative diagnosis of schwannoma is difficult, and although PET may be a useful adjunct to CT and MRI, it is not always possible to differentiate between benign and malignant lesions.…”

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confidence: 99%

Giant obturator schwannoma: an unusual finding in a patient with prostate cancer

Sousa

Frydenberg

2012

ANZ Journal of Surgery

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A 58-year-old man was found to have a large retroperitoneal pelvic mass on a staging computed tomography (CT) scan for newly diagnosed high-risk prostate cancer (Figs 1,2). He was asymptomatic and referred with a screen-detected elevated prostate specific antigen of 22; subsequent prostate biopsies revealed Gleason 8 (4 + 4) in 9 of 12 cores. A staging bone scan demonstrated no evidence of skeletal metastases; the CT scan was otherwise unremarkable.Magnetic resonance imaging (MRI) and ultrasound were performed in an attempt to further characterize the nature of the lesion. The ovoid, heterogeneous mass appeared encapsulated and was seen in the left side of the pelvis, displacing the bladder to the right. It measured 75 ¥ 85 ¥ 100 mm in maximal dimensions and was seen to be arising in the retroperitoneum, abutting the left obturator internus muscle. A clear plane was seen to separate the mass from both bladder and prostate. Given the clinical scenario, a giant malignant lymph node was considered one of the possible diagnoses.The management plan was for open radical prostatectomy and pelvic lymph node dissection including excision of the mass. A low midline incision and extraperitoneal approach easily exposed the prominent mass. It was as expected, separate from the bladder and prostate; however, it was densely adherent to the left pelvic sidewall, making dissection difficult. The obturator nerve could not be identified on that side of the pelvis. The mass was excised intact, and a specimen sent for frozen section, which was non-diagnostic, however, indicated that the lesion appeared neither nodal nor malignant in nature.Following excision of the mass, a structure thought to be a transacted-free end of the obturator nerve was identified; a neurosurgeon was consulted who attended and advised no further action until a clinical assessment was made. Surgery proceeded to radical prostatectomy with lymph node dissection and was completed without further event.Post-operatively, the patient and his wife were counselled as to the possibility of an obturator nerve injury. At this point, they revealed that the patient had experienced several years of persistent pain and paraesthesia in the medial aspect of the left knee, along with a gait disturbance, which was consistent with obturator neuropathy. The symptoms had previously been attributed to an old sporting injury without further investigation. Follow-up of the patient reveals a mild weakness in thigh adduction; however, the pain previously Fig. 1. Computed tomogram image of the large retroperitoneal pelvic mass arising from the pelvic sidewall.Fig. 2. Coronal view demonstrating a plane separating the mass from both bladder and prostate.

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Compressive and Entrapment Neuropathies of the Lower Extremity

Katirji

2013

Neuromuscular Disorders in Clinical Practice

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Benign schwannoma of the obturator nerve: A case report

Cited by 11 publications

References 2 publications

Laparoscopically resected obturator nerve schwannoma: A case report

Laparoscopically resected obturator nerve schwannoma: A case report

Giant obturator schwannoma: an unusual finding in a patient with prostate cancer

Compressive and Entrapment Neuropathies of the Lower Extremity

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