Case Report

Evaluation of Perinephric, Retroperitoneal Schwannomas: Case Report and Review of the Literature

Authors: Ikuho Ohta, MD, Po-Hsun Lin, MD, Chuo-Li Rau, MD, Kwei-Chin Wang, MD

Abstract

Schwannomas are tumors arising from the nerve sheath. Because of their infrequent occurrence, nonspecific symptoms, and lack of distinguishing radiologic features, schwannomas are most often diagnosed histologically after surgical excision. We report herein a case of a perinephric, retroperitoneal schwannoma which, after evaluation by computed tomography, magnetic resonance, and angiography, appeared to be a renal cell carcinoma arising from the left kidney. The diagnosis of benign retroperitoneal schwannoma was made by histologic examination and immunohistochemical staining of the excised mass. A practical algorithm for perinephric, retroperitoneal schwannomas is proposed.


Key Points


* Schwannomas are rare tumors that are difficult to diagnose preoperatively.


* Evaluation of perinephric, retroperitoneal masses should preferably include magnetic resonance imaging rather than computed tomography.


* Core biopsies, but not needle biopsies, may assist in the preoperative diagnosis.


* Complete surgical excision is indicated and recurrence is rare.


* Histologic and immunohistologic staining should be used to confirm the diagnosis.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Chew BH, Knudsen BE, Moussa M, et al. A retroperitoneal gastrointestinal schwannoma presenting as a perinephric mass. Can J Urol 2005;12:2555–2556.
 
2. Dede M, Yaqci G, Yenen MC, et al. Retroperitoneal benign schwannoma: report of three cases and analysis of clinico-radiologic findings. Tohoku J Exp Med 2003;200:93–97.
 
3. Funamizu N, Sasaki A, Matsumoto T, et al. Laparoscopic resection of a retroperitoneal schwannoma behind the lesser omental sac. Surg Laparosc Endosc Percutan Tech 2004;14:175–177.
 
4. Hughes MJ, Thomas JM, Fisher C, et al. Imaging features of retroperitoneal and pelvic schwannomas. Clin Radiol 2005;60:886–893.
 
5. Sharma SK, Koleski FC, Husain AN, et al. Retroperitoneal schwannoma mimicking an adrenal lesion. World J Urol 2002;20:232–233.
 
6. Schindler OS, Dixon JH, Case P. Retroperitoneal giant schwannomas: report on two cases and review of the literature. J Orthop Surg 2002;10:77–84.
 
7. Gubbay AD, Moschilla G, Gray BN, et al. Retroperitoneal schwannoma: a case series and review. Aust N Z J Surg 1995;65:197–200.
 
8. Behrend M, Kaaden S, Von Wasielewski R, et al. Benign retroperitoneal schwannoma mimicking an adrenal mass. Surg Laparosc Endosc Percutan Tech 2003;13:133–138.
 
9. Hsiao WC, Lin PW, Chang KC. Benign retroperitoneal schwannoma mimicking a pancreatic cystic tumor: case report and literature review. Hepatogastroenterology 1998;45:2418–2420.
 
10. Kishi Y, Kajuwara S, Seta S, et al. Retroperitoneal schwannoma misdiagnosed as a psoas abscess: report of a case. Surg Today 2002;32:849–852.
 
11. Hettiarachchi JA, Finkelstein MP, Schwartz AM, et al. Benign retroperitoneal schwannoma presenting as a giant adrenal tumor. Urol Int 2003;71:231–232.
 
12. Nasu K, Arima K, Yoshimatsu J, et al. CT and MRI findings in a case of pelvic schwannoma. Gynecol Obstet Invest 1998;46:142–144.
 
13. Hayasaka K, Yamada T, Saitoh Y, et al. CT evaluation of primary benign retroperitoneal tumor. Radiat Med 1994;12:115–120.
 
14. Daneshmand S, Youssefzadeh D, Chamie K, et al. Benign retroperitoneal schwannoma: a case series and review of the literature. Urology 2003;62:993–997.
 
15. Lin CS, Hsu HS, Tsai CH, et al. Gastric schwannoma. J Chin Med Assoc 2004;67:583–586.