Giant presacral schwannoma presenting with constipation: a case report

Abstract

IntroductionSchwannoma, otherwise known as a neurilemmoma, is a tumor arising from peripheral nerve sheaths. Although commonly noted in association with the eighth cranial nerve as intracranial acoustic neuroma, cases of schwannoma arising in other locations have been reported in the literature. These tumors usually cause symptoms as a result of their mass effect and, since they are benign, encapsulated and non-invasive tumors, complete surgical excision is considered curative.Case presentationWe report the case of a 46-year-old Sri Lankan man who presented to our facility with recent onset of difficulty evacuating his bowels. He was noted to have a giant presacral schwannoma on magnetic resonance imaging scan. The mass was surgically excised with improvement of our patient’s symptoms. A subsequent histopathological examination confirmed the presence of a benign schwannoma.ConclusionsAlthough schwannomas commonly occur in the extremities, a rare case of occurrence in the pelvis is reported here. Due to the limited space in the pelvis, the local mass effect may be the presenting feature of such a lesion and surgical excision is curative.

Management approach and surgical strategies for retrorectal tumours: a systematic review

“…They have been seen incidentally during gynaecological surgery and staging in breast malignancy . When symptomatic they may present with pain in the pelvis, back or abdomen, constipation , large bowel obstruction , palpable rectal mass , recurrent pilonidal sinus , pelvic and perianal abscess formation, irritable bowel syndrome and abnormal gait . The clinical presentation is heterogeneous and retrorectal tumours often pose diagnostic difficulty as non‐specific chronic pain and suppuration are the commonest symptoms .…”

Schwannoma with an uncommon anal location

“…These tumors, although rare, should be considered in the differential diagnosis of slow-growing masses of an anal location, such as lipomyomas. The growth of these masses occasionally causes displacement and compression of the nerve of origin, resulting in clinical signs and symptoms ( 3 ). The tumors can develop in either of the two genders and there is no age predilection ( 4 ).…”

“…The tumors can develop in either of the two genders and there is no age predilection ( 4 ). Surgical excision is the treatment of choice for schwannomas ( 3 ). In the present study, the case of a patient with an anal schwannoma is reported, where the pre-operative clinical diagnosis was inconclusive and the final diagnosis was established based on radiographic and histopathological examination.…”

A rare case of schwannoma mimicking ovarian tumour

“…10 In a Srilankan case report, the patient presented with constipation due to a giant presacral schwannoma. 11 There has also been a case report, where sacral schwannoma mimicked an aneurysmal bone cyst. 12 Another similar case of retroperitoneal mass obliterating the rectouterine pouch was found to be a degenerated cystic schwannoma in a young woman.…”