Diagnostic Difficulty in Retroperitoneal Mass: A Case Report View PDF

Mariana Y Gallosa
Medicine, General Surgery Service Teaching Polyclinic, Autonomous City Of Buenos Aires, Buenos Aires, Argentina

Published on: 2024-10-02

Abstract

Schwannoma, a benign tumor that arises from Schwann cells of the perineural nerve sheath, is often incidentally detected in imaging tests and mainly diagnosed by computed tomography (CT) scan. Treatment consists of surgical resection with clear margins. We present the case of a 49-year-old female patient subject to oncology department follow-up due to an underlying disease, left breast cancer. A large, hypermetabolic, non-cystic mass in the retroperitoneal region is identified by CT and positron emission tomography (PET)/CT scan in the left lateral aortic area. A percutaneous biopsy is requested. Due to the limited acoustic window, complete resection of the mass is decided. Final histopathology diagnosis of schwannoma. No adjuvant treatment indication undergoing favorable postoperative progress, without recurrence.

Keywords

Differential diagnosis, Retroperitoneal mass, Schwannoma

Introduction

Retroperitoneal masses may have multiple origins, such as initial diagnoses, nodal metastasis, and lymphoproliferative disorders, which require ruling out primary diseases. Retroperitoneal nerve sheath tumors constitute 10 - 20% of primary retroperitoneal tumors, including schwannomas, neurofibromas, neurofibromatosis, and malignant nerve sheath tumors [1]. Compared to mesenchymal tumors, neurogenic tumors occur in younger age groups, are more likely to be benign, and have a better prognosis [2]. Schwannoma, also known as neurilemoma, originates from the perineural sheath of the Schwann cell and represents 6% of retroperitoneal neoplasms. It is more common than neurofibroma, and the gender frequency radio shows a higher prevalence in women (2:1) between the ages of 20 and 50 [3].