Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

Singh, Mastan; Kumar, Love; Chejara, Rajkumar; Prasad, Om Prakash; Kolhe, Yuvraj; Saxena, Amita

doi:10.1155/2014/628538

Cited by 11 publications

(16 citation statements)

References 10 publications

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“…In controversial cases, the mitotic index plays a vital role. In malignant schwannoma cases, there is an increase in the mitotic index and irregular infiltrates to the nuclear atypia and surrounding tissues (10,11). In our case, the malignancy criterion was not observed.…”

Section: Discussionmentioning

confidence: 47%

Giant retroperitoneal ancient schwannoma: An unusual schwannoma type in the rarest localization

Uysal¹,

Maralcan²,

Kirdak³

et al. 2017

Eur J Ther

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Schwannomas are tumors originating from Schwann cells in the nerve sheath. Although they can appear on many parts of the body, they occur most frequently in the head and neck. Furthermore, they are very rarely seen in the retroperitoneal region. Ancient schwannoma is a sub-type of schwannomas that is quite rare. In this study, the case of a retroperitoneal ancient schwannoma, which showed cystic degeneration and reached gigantic sizes, is presented. A forty-nine-year-old female patient was admitted to our center with complaints of growing abdominal distention and stiffness for 7 years. In the physical examination, a non-mobile and stiff mass that was approximately 30 cm along its longest axis and extended from the subcostal area to the inguinal region was detected on the right side of the abdomen. A solid retroperitoneal mass containing encapsulated and cystic components was confirmed in the oral and intravenous contrasted abdominopelvic tomography. The size of the mass was 28×20×12 cm, and a total excision of the mass was planned. The mass was excised together with the capsule. In the pathological examination, ancient schwannoma, which showed widespread multifocal cystic degeneration with benign characteristic, was found. In the immunohistochemical staining, S100 was found to be positive. The patient was discharged on the 5th postoperative day. Schwannomas are slowly progressive benign tumors that can reach a large size without any symptoms and rarely settle in the retroperitoneal region. Ancient schwannomas are also a rarely seen sub-type of schwannomas. In this study, the case of a retroperitoneal ancient schwannoma, which showed cystic degeneration and reached gigantic sizes, is presented. Keywords: Giant, retroperitoneal, ancient, schwannoma ÖZ Schwannoma'lar, sinir kılıflarındaki schwann hücrelerinden köken alan tümörlerdir. Vücudun pek çok bölgesinden kaynaklanabilirler. En sık olarak baş boyun bölgesinde görülürler. Retroperitoneal bölgede ise oldukça nadirdirler Ancient schwannoma ise oldukça az görülen bir subtipdir. Bu vaka sunumunda; nadir görülen, kistik dejenerasyon göstermiş ve dev boyutlara ulaşmış retroperitoneal ancient schwannoma olgusu sunulmuştur. Kırk dokuz yaşında kadın hasta, merkezimize 7yıldır karında giderek büyüyen şişlik ve sertlik şikayeti ile başvurdu. Fizik muayenede karnın sağ tarafında; subkostal alandan inguinal bölgeye kadar uzanan sert, mobilitesi olmayan ve uzun ekseni yaklaşık 30cm olan kitle palpe edildi. Oral ve intravenöz kontrastlı abdominopelvik tomografide enkapsüle, kistik komponentler de içeren solid retroperitoneal kitle saptandı. Kitlenin boyutu 28x20x12 cm boyutlarında idi. Kitlenin total eksizyonu planlandı. Kitle, kapsülü ile birlikte total olarak çıkarıldı. Patolojik incelemede yaygın multifokal kistik dejenerasyon gösteren benign karakterli ancient schwannoma tespit edildi. İmmünohistokimyasal boyamada S100 pozitif bulundu. Hasta ameliyat sonrası 5. günde taburcu edildi. Schwannomalar yavaş seyirli benign tümörlerdir. Belirti vermeden dev boyutlara ul...

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Section: Discussionmentioning

confidence: 47%

Giant retroperitoneal ancient schwannoma: An unusual schwannoma type in the rarest localization

Uysal¹,

Maralcan²,

Kirdak³

et al. 2017

Eur J Ther

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show abstract

“…The most common symptom is blunt abdominal pain accompanied by abdominal distension. [9] Although ultrasonography, CT, and MRI reveal the features of schwannoma, they are not sufficient for a definitive preoperative diagnosis. In literature, schwannomas have been reported to have been determined with these tests at the rate of 15.9%.…”

Section: Discussionmentioning

confidence: 99%

A giant ancient schwannoma mimicking an adnexal mass

Karaköse

Pülat

Oguz³

et al. 2016

Medicine

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Introduction:Ancient schwannoma is a rare tumor of the peripheral nerve sheath. As degenerative properties are defined histologically, it can be wrongly interpreted as malignant.Case presentation:The case presented here is of a giant ancient schwannoma with a pelvic retroperitoneal location, which was mimicking an adnexal mass.Conclusion:In the rarely seen cases in the retroperitoneum, it may reach very large dimensions.

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“…Singh et al [12], in their case of a large, infected retroperitoneal schwannoma, did not perform debridement and irrigation following removal of the tumor, although the postoperative recovery was purportedly uneventful. In the present case, the authors performed debridement and irrigation of devitalized peritumoral tissue following tumor enucleation.…”

Section: Discussionmentioning

confidence: 99%

“…After a thorough review and to the best of the authors’ knowledge, this is one of the only four cases of infected schwannoma reported in the literature. The other three were cases of infected gastric [11], retroperitoneal [12], and glossal [13] schwannomas. But more interesting than the rarity of infected schwannoma is the diagnostic challenge that a similar vagueness of its clinical presentation poses to the treating tumor surgeon.…”

Section: Introductionmentioning

confidence: 99%

A case of infected schwannoma mimicking malignant tumor

et al. 2016

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BackgroundInfected schwannoma has been reported, this being one of the four cases published in the literature. Infected schwannoma has proven to be a tough diagnostic challenge to the treating tumor surgeon, mimicking infectious entities and most essentially, a malignant tumor.Case presentationThe authors report the case of a 64-year-old male with a soft tissue mass in his right gluteal area that presented initially with right leg pain, then later with signs of inflammation on the tumor area. Magnetic resonance imaging (MRI), computed tomography (CT), and thallium-201 scintigraphy studies confirm the presence of soft tissue mass which had continuity with sciatic nerve, with subsequent serial MRI findings suggesting tumor enlargement with cystic degeneration. Increased level of C-reactive protein (CRP) was observed before surgery. During an open biopsy upon tissue sampling, exudates with necrotic tissue were seen. Increased level of CRP and necrotic change suggested the possibility of malignant tumor. Histopathological diagnosis was schwannoma, and group B Streptococcus was detected by culture. After the confirmation of infected schwannoma, enucleation of the tumor was performed.ConclusionsThe report concludes that establishment of a benign pathology is essential when presented with similar clinical findings prior to definitive enucleation of an infected schwannoma.

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Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

Cited by 11 publications

References 10 publications

Giant retroperitoneal ancient schwannoma: An unusual schwannoma type in the rarest localization

Giant retroperitoneal ancient schwannoma: An unusual schwannoma type in the rarest localization

A giant ancient schwannoma mimicking an adnexal mass

A case of infected schwannoma mimicking malignant tumor

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