Laparoscopic Management of Obturator Nerve Schwannomas

Ningshu, Lin; Yin, Min; Yang, Xie-qiao; Yao, Yuanqing; Xiaoqiang, Mao; Li, Rubing

doi:10.1097/sle.0b013e3182478870

Cited by 30 publications

(21 citation statements)

References 16 publications

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“…Pelvic tumors and, more specifically, pelvic schwannomas can cause chronic pelvic pain, as was reported in a case of a femoral nerve schwannoma that was clinically expressed with the symptom of chronic pelvic pain 6. There were two cases of obturator nerve tumors arising from the Schwann cells, one expressed as a pelvic tumor and the other as an ovarian tumor 20. Nine cases of schwannomas mimicking ovarian malignancies have also been reported 21,22…”

Section: Resultsmentioning

confidence: 93%

Pelvic schwannoma in the right parametrium

Machairiotis¹,

Stylianaki²,

Karatrasoglou³

et al. 2013

IJGM

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Neurilemomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells. These tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area (less than 0.5% of reported cases), unless they are combined with von Recklinghausen disease (type 1 neurofibromatosis). We report the case of a 58-year-old female with pelvic schwannoma, 6.5 × 5.5 cm in size, in the right parametrium. This is the first case reported in the literature. Based on the rarity of this tumor and in order to ensure optimum treatment and survival for our patient, we performed laparotomy with total abdominal hysterectomy and en-block tumor excision. A frozen section was taken during the surgery before complete resection of the mass, which was ambiguous. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; diagnosis was a schwannoma. There were degenerative areas, including cystic degeneration, hemorrhagic infiltrations, ischemic foci with pycnotic cells, and collagen replacement. Pelvic schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumors and might offer the advantage of better visualization of structures due to the magnification in laparoscopic view, especially in narrow anatomic spaces.

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Section: Resultsmentioning

confidence: 93%

Pelvic schwannoma in the right parametrium

Machairiotis¹,

Stylianaki²,

Karatrasoglou³

et al. 2013

IJGM

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“…Obturator nerve schwannomas are exceedingly rare, with only a handful cases published worldwide in the English language, with the first published in 1998 [ 5 ]. Subsequent individual case reports and one series of 6 cases have commented on experiences with laparascopic and robotic resections of obturator nerve schwannomas [ 3 , 6 , 7 ]. Of note, this is the first case to our knowledge to discuss the benefits of preoperative contrast-enhanced MRI and postoperative pathologic analysis of these exceedingly rare tumors.…”

Section: Discussionmentioning

confidence: 99%

Obturator Nerve Schwannoma as a Mimic of Ovarian Malignancy

Gleason

Parthasarathy

et al. 2017

Case Reports in Obstetrics and Gynecology

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The obturator nerve is an extremely rare location for schwannomas to originate, and such diagnosis is typically not considered among the imaging diagnostic possibilities for a cystic-solid pelvic mass. A 63-year-old female with a known pelvic mass presented with increasing pelvic pain. The mass, which had been followed by serial imaging over five years, was described showing mixed solid and cystic components, likely arising from the left ovary. Although the key diagnosis to be excluded was a primary ovarian malignancy, the patient chose to pursue active surveillance. Over the five years of close observation, the lesion increased slowly, while her CA-125 level showed no significant elevation. Increase in size of the mass and worsening pain and concern for a gynecologic malignancy on MRI led her to ultimately consent to a hysterectomy with bilateral salpingooophorectomy. During the surgery, the mass was noted to be contiguous with the left obturator nerve. Pathologic evaluation revealed a schwannoma (WHO grade I). The patient's postsurgical course was uneventful, without residual weakness in the left adductor muscles.

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“…[6] There were two cases of obturator nerve tumours arising from Schwann cells, one expressed as a pelvic tumour and the other as an ovarian tumour. [20] Nine cases of schwannomas mimicking ovarian malignancies have also been reported. [21,22] Pelvic schwannomas, as mentioned above, are easily misdiagnosed owing to the lack of [23] Because the vast majority of schwannomas are benign tumours, simple tumour enucleation could also be effective.…”

Section: Discussionmentioning

confidence: 99%