Image features and clinical analysis of retroperitoneal pelvic schwannoma: a case report

• Published in: BMC neurology Vol. 24; no. 1; pp. 230 - 7
• Main Authors: Wu, Xining, Meng, Hua, Fan, Qingbo, Qi, Zhenhong, Pan, Weidong
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 03.07.2024; BioMed Central; BMC
• Subjects: Abdomen; Acoustic neuroma; Analysis; Bladder; Care and treatment; Case Report; Cranial nerves; Diagnosis; Differential diagnosis; Female; Femoral; Femur; Gynecology; Hospitals; Humans; Image processing; Laparoscopy; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Malignancy; Middle Aged; Morbidity; Nerve proteins; Neurilemmoma - diagnosis; Neurilemmoma - diagnostic imaging; Neurilemmoma - pathology; Neurilemmoma - surgery; Ovaries; Pain; Pelvic; Pelvis; Retroperitoneal; Retroperitoneal Neoplasms - diagnosis; Retroperitoneal Neoplasms - diagnostic imaging; Retroperitoneal Neoplasms - pathology; Retroperitoneal Neoplasms - surgery; Risk factors; S100 protein; Schwann cells; Schwannoma; Surgery; Tomography; Tumors; Ultrasonic imaging; Uterus; China; Retroperitoneal; Pelvic; Femoral; Schwannoma
• DOI: 10.1186/s12883-024-03715-y
• ISSN: 1471-2377

Schwannomas are benign usually encapsulated nerve sheath tumors derived from the Schwann cells, and affecting single or multiple nerves. The tumors commonly arise from the cranial nerves as acoustic neurinomas but they are extremely rare in the pelvis and the retroperitoneal area. Retroperitoneal pelvic schwannomas often present with non-specific symptoms leading to misdiagnosis and prolonged morbidity. We report the case of a 59-year-old woman presenting with a feeling of heaviness in the lower abdomen who was found to have a retroperitoneal pelvic schwannoma originating from the right femoral nerve. She had a history of two resections of peripheral schwannomas at four different sites of limbs. After conducting magnetic resonance imaging, this pelvic schwannoma was misdiagnosed as a gynecological malignancy. The tumor was successfully removed by laparoscopic surgery. Pathological analysis of the mass revealed a benign schwannoma of the femoral nerve sheath with demonstrating strong, diffuse positivity for S-100 protein. Although retroperitoneal pelvic schwannoma is rare, it should be considered in the differential diagnosis of pelvic masses, especially in patients with a history of neurogenic mass or the presence of neurogenic mass elsewhere.