Laparoscopic resection of a giant retroperitoneal melanotic schwannoma

Abstract

BackgroundRetroperitoneal schwannomas are extremely rare, as they account for only 3% of retroperitoneal tumors. Clinical symptoms are nonspecific and of late onset, meaning that these tumors are diagnosed at an advanced stage. Surgical resection is required for histological diagnosis and to prevent possible malignant transformation. Celioscopy offers numerous benefits, reducing postoperative pain and speeding up the patient’s return to autonomy, but it can pose a real challenge due to the size of these lesions.Case presentationWe report a case of laparoscopic resection of a very large right-sided retroperitoneal schwannoma, with a particular histological form.ConclusionSurgical resection in a single unit remains the golden rule, and a laparoscopy can be proposed when the diagnosis is beyond doubt. The large size of the retroperitoneal melanotic schwannomas, a common feature, increases surgical difficulties but is not a contraindication to this approach.

Retroperitoneal Recurrence of Melanotic Schwannoma on 18F-FDG PET/CT

“…Melanotic schwannoma generally arises from the roots of spinal nerves, or soft tissues occasionally, but can also occur in the bone, sympathetic chain, cerebella, heart, liver, choroid, retroperitoneum, and skin. These tumors are usually benign, but they may become aggressive and metastatic 6–9 . Our case shows that melanotic schwannoma can have intense 18 F-FDG activity on PET/CT study.…”

“…These tumors are usually benign, but they may become aggressive and metastatic. [6][7][8][9] Our case shows that melanotic schwannoma can have intense 18…”

Indocyanine green fluorescence imaging-assisted laparoscopy resection of retroperitoneal tumors in children: case report and literature review

“…The complex nature of retroperitoneal tumors, characterized by their size, vascularity, potential malignancy, and proximity to major vessels and tissues, complicates complete resection and elevates the risk of vascular injury. Historically, tumors larger than 6 cm were deemed relatively unsuitable for laparoscopic removal ( 7 ), yet recent reports have documented the successful resection of even larger tumors, sparking an ongoing debate about the procedure ( 8 , 9 ). Scholars contend that size alone should not preclude laparoscopic intervention, provided preoperative assessments ensure intact tumor capsules, the absence of midline crossing, clear demarcation, and no major vessel invasion ( 10 – 12 ).…”

A para-aortic malignant melanotic nerve sheath tumor mimicking a gastrointestinal stromal tumor: a rare case report and review of literature

“… Ref. number Age Sex Site Size (cm) Cystic or necrosis Symptom Treatment Follow-up/outcome 1[ 7 ] 57 M Retro, Rt upper 17 + Urethrorrhagia GTR No report 2[ 8 ] 40 F Intercostal near liver 3.9 − Rt Abd pain GTR; R/T & C/T after mets 3 yrs/mets and died 3[ 9 ] 42 M Near Rt adrenal 3.8 − No GTR 30 mons well 4[ 10 ] 16 F Mesosigmoid 19 − Abd discomfort GTR 3 yrs well 5[ 2 ] 46 F Para-aortic 3 N/A N/A GTR 60 mons well 6[ 11 ] 59 M Rt renal 15 + …”

“…GISTs are the most common mesenchymal tumors [ 19 ]; therefore, GISTs and MMNSTs should be distinguished. CT scan findings indicate that GISTs seldom show calcification, but calcification may be seen in some MMNSTs [ 7 – 9 , 28 ]. MRI findings typically show MMNST as having T1 hyperintensity and T2 hypointensity due to the presence of melanin contained in MMNST.…”