scholarly journals Diagnostic Dilemma of a Rare, Giant Retroperitoneal Schwannoma: A Case Report and Review of Literature

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mahendra Singh ◽  
Lovekesh Kumar ◽  
Rajkumar Chejara ◽  
Om Prakash Prasad ◽  
Yuvraj Kolhe ◽  
...  

Schwannoma is a benign tumour of peripheral nerve sheath. It usually arises from head, neck, and trunk. Retroperitoneal schwannoma is a rare entity, accounting for only 0.3–3% of total schwannomas. Majority of retroperitoneal schwannomas reported in literature have a diameter of 5 to 15 cm. Preoperative diagnosis is difficult due to low frequency, nonspecific clinical course, and nonspecific imaging features. Histology usually provides definitive diagnosis. Schwannomas are solitary, well-circumscribed, and noninvasive, so complete surgical excision provides good result. We report a case of a 23-year-old male, who presented with progressive abdominal distension and intermittent episodes of intestinal obstruction. CECT was suggestive of huge solid-cystic mass in abdominopelvic region. Image guided percutaneous aspiration revealed around 1 litre of frank pus and FNAC was suggestive of abscess. Exploratory laparotomy revealed a large 32 × 28 × 26 cm mass with solid and cystic components containing 1 litre of pus. Histological features of tumour were suggestive of benign schwannoma and immunohistochemistry for S-100 was positive. Postoperative recovery was uneventful. We report this case of a retroperitoneal schwannoma because of giant size, rare location, unusual presentation, and diagnostic dilemma.

2015 ◽  
Vol 20 (3) ◽  
pp. 266-268 ◽  
Author(s):  
Gabriel Rodrigues ◽  
Raghunath Prabhu

Background: Hydatid disease, or echinococcosis, affects several organs in the body and can pose a major diagnostic dilemma. Musculoskeletal involvement occurs only in 1% to 6% of patients. Clinically, the condition mimics a soft tissue tumor, and a preoperative diagnosis (blood and radiology) is necessary to avoid biopsy, management, and recurrence. In endemic areas, a differential diagnosis of hydatid disease should be considered for every soft cystic mass in any anatomic location. Methods: The investigators report a rare case of primary subcutaneous hydatid cyst of the thigh, which was an incidental clinical and radiologic finding that led to a diagnostic dilemma in a 62-year-old woman with diabetes admitted for management of a nonhealing foot ulcer. Results: The patient underwent successful complete surgical excision with pre- and postoperative antihelminthic pharmacotherapy, and at the end of 2-year follow-up, there has been no local recurrence or systemic disease.


2021 ◽  
Vol 14 (5) ◽  
pp. e243302
Author(s):  
Kazuki Mitani ◽  
Elena Yukie Uebayashi ◽  
Hisanori Fujino ◽  
Shinichi Sumimoto

A 9-month-old girl presented with progressive abdominal distension. Imaging revealed a huge cystic mass in the left retroperitoneum with solid components. The right kidney was absent and hydrometrocolpos was found. Tumour drainage and complete surgical excision were performed. A bulge in the right side of the uterus, suggestive of a uterine anomaly, was seen on laparoscopic observation. Pathology was consistent with teratoma with a small portion of immature neural tissue. The patient was discharged in good condition and was advised regular follow-up.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 728
Author(s):  
Jeong-Hyouk Choi ◽  
Koo-Han Yoo ◽  
Dong-Gi Lee ◽  
Gyeong-Eun Min ◽  
Gou-Young Kim ◽  
...  

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.


2021 ◽  
Vol 42 (05) ◽  
pp. 506-509
Author(s):  
Nidhi Gupta ◽  
Awadhesh Kumar Pandey ◽  
Kislay Dimri ◽  
Surinder K Singhal ◽  
Neeraj Rathee ◽  
...  

AbstractChondrosarcomas are the second most common primary malignant bone tumors. Head and neck chondrosarcomas constitute less than 10% of these tumors, rarely arising from the nasal septum. These are locally aggressive malignant tumors arising from the cartilaginous framework of the nasal septum. Rarity of the tumor coupled with nonspecific symptoms makes it a diagnostic dilemma. Diagnosis requires endoscopy, radiology, and final histopathology for confirmation. Treatment is mainly surgical, requiring complete surgical excision with clear margins. Radiation has a role in unresectable tumors or for tumors with positive margins after surgery. Survival depends on the grade of tumor that predicts the metastatic potential of the tumor. We present a rare case of chondrosarcoma arising from the nasal septum in a 29-year-old young female presenting with complaints of nasal obstruction. Computed tomography was suggestive of a calcified cartilaginous tumor arising from the nasal septum. Endoscopic excision was done and postoperative histopathology showed grade II chondrosarcoma with clear margins. No adjuvant treatment was given to our patient and 2 years post-excision patient is disease free.To conclude, chondrosarcoma of the nasal septum is a rare tumor, with nonspecific symptoms. Surgery with clear margins remains the treatment of choice. Prognosis depends on the extent of tumor at presentation, resection margins, and grade of tumor.


2020 ◽  
Vol 2020 (7) ◽  
Author(s):  
Paul Burchard ◽  
Alan A Thomay

Abstract A 53-year-old Caucasian male presented with a 2-week history of abdominal distension, pain, nausea and lethargy. His symptoms began 1 day after an all-terrain vehicle accident during which he suffered blunt-force trauma to his mid-right abdomen. CT scan demonstrated abnormal thickening of the ascending colon and terminal ilium with surrounding inflammation within the retroperitoneum and colonic mesentery. Given his likely mechanism and symptomatic improvement, he was initially managed conservatively. However, he was readmitted with recurrence of symptoms, and a repeat CT scan demonstrated no interval improvement. An exploratory laparotomy was performed and a firm, fixed mass of the right-colon and colonic mesentery was found. Final histopathology of the mass revealed a diffuse lymphoid infiltrate with numerous mitotic figures and apoptotic cells. Immunohistochemical staining was positive for CD45, CD20, CD10, and BCL-6 and negative for CD3, TdT, and BCL-2, indicating a diagnosis of Burkitt lymphoma.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Santhosh Kuriakose ◽  
Syam Vikram ◽  
Surij Salih ◽  
Satheesan Balasubramanian ◽  
Nizamudeen Mangalasseri Pareekutty ◽  
...  

Ancient Schwannoma, though benign, can cause diagnostic dilemma because of its clinical presentation and imaging features. We report the management of a giant retroperitoneal schwannoma in a 19-year-old young lady who presented with lower abdominal distension. CT scan reported a large heterogenous lesion in the abdominopelvic retroperitoneum (42 cm × 16 cm × 16 cm) as a malignant tumor. The unique problems we encountered were the enormous size, the location of major part of the tumor in the pelvis, the need for fertility preservation, the external iliac vessels stretching over the tumor making mobilization surgically demanding, and the prospects of neurological deficits. An en bloc resection of schwannoma with common iliac, external iliac and internal iliac veins, internal iliac artery, femoral and obturator nerves, and iliopsoas muscle was done maintaining oncological principles. External iliac artery that was cut to facilitate tumor mobilization was reanastomosed at the end of the procedure. Postoperatively patient had uneventful recovery with patchy sensory loss, foot drop, and quadriceps weakness which was rehabilitated with a foot drop splint and active physiotherapy.


2020 ◽  
Vol 7 (11) ◽  
pp. 3785
Author(s):  
Mahmood A. Makhdoomi ◽  
Abdulaziz Almotlaq ◽  
Nader A. Tawfiq

A 47 years old Saudi male was admitted to king Khalid hospital with complaints of constipation and abdominal distension. Abdominal examination showed as a case of intestinal obstruction. He was fully evaluated and was treated first conservatively, until all investigative study confirmed as huge small bowel dilatation (mainly jejunum). Exploratory laparotomy confirmed small bowel tumor and on histology an adenocarcinoma. The introduction, history and research paper will also be discussed in this report.


2021 ◽  
Vol 8 (2) ◽  
pp. 752
Author(s):  
D. J. Balsarkar ◽  
Sachin A. Suryawanshi ◽  
Muna Shaikh ◽  
Sudhir Dhobale

Lipoma is the most common benign tumor of adipose tissue. Giant lipoma of breast is very rare.Majority of them are small in size, slow growing and asymptomatic until they reach large size. Most patients seek medical advice due to asymmetry in the breast and due to fear of malignancy. Breast lipomas pose a diagnostic challenge due to similarity of their texture to normal breast parenchyma and make it difficult to distinguish from other common breast lesions. The clinical and radiographic identification of breast lipoma remains challenging. Complete surgical excision with the capsule is essential to prevent recurrence. Breast reconstruction may require, to prevent asymmetry following surgical excision of giant breast lipoma. High degree of clinical suspicion and histolopathological correlation will help in preopertaive diagnosis of this clinical condition. Here, we report a case 50- year -old woman with left breast lump which clinically, radiologically and on fine needle aspiration cytology was diagnosed as phyllodes tumor, but after surgical excision it was reported as breast lipoma on final histopathology.


2021 ◽  
Vol 7 (2) ◽  
pp. 28-31
Author(s):  
Deki Choden ◽  
Kinley Sangay Dorji ◽  
Sonam Choden

ABSTRACTRetroperitoneal teratoma is a extragonadal germ cell tumor comprising 5% of all teratomas in children, and the third most common retroperitoneal neoplasm in children. This is a case report of a 2 years old girl who presented with abdominal distension and palpable mass. The imaging findings of the mass was characteristic of retroperitoneal teratoma which was confirmed by histopathology report following complete excision. Retroperitoneal tumor is an uncommon tumor in children with characteristic imaging findings. Computed tomography is mainly used to evaluate the extent of the disease. Most of the retroperitoneal tumors are benign and curable with complete surgical excision.


2010 ◽  
Vol 25 (2) ◽  
pp. 27-31
Author(s):  
Adrian F. Fernando ◽  
Antonio H. Chua ◽  
Lily L. Sia-Vargas

Objective:  To present a rare case of nodular fasciitis presenting as a supra-auricular mass.   Methods: Design: Case Report Setting: Private Tertiary University Hospital Patient: One   Results: A one-year-old boy presented with an initially painless, left supra-auricular mass that rapidly enlarged from < 1 cm to 3 cm (widest diameter) in a two-month period. Sarcoma was initially considered over an inflammatory process as the mass was non-responsive to antibiotic therapy. Fine-Needle Aspiration Cytology (FNAC) and High-Resolution Computed Tomography (HRCT) with contrast revealed benign cytologic and radiologic findings making nodular fasciitis the primary impression.               The patient eventually underwent complete surgical excision of the left supra-auricular mass. Histopathologic findings then showed a stroma rich in collagen and myxoid ground substance and loose array of short S-shaped fascicle cells with scattered lymphocytes, macrophages and red blood cells consistent with nodular fasciitis.   Conclusion: Nodular fasciitis is a rare benign myofibroblastic soft tissue tumor which typically presents as a rapidly progressive nodular lesion in the head and neck region of the young pediatric age group. Cytopathologic recognition with FNA is a challenge. The gold standard of treatment is still surgical and in most reported cases, curative. More importantly, early clinical recognition and correlation with radiologic and histopathologic appearance is very important to avoid unnecessary work-ups and over-treatment.   Keywords: Nodular fasciitis; pseudosarcomatous fasciits; aggressive fibromatosis, desmoid tumor


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