Clinical Characteristics and Treatment Strategy of Retroperitoneal Schwannoma Adjacent to Important Abdominal Vessels: Three Case Reports and Literature Review

Purpose: The purpose of this study was to review the clinical characteristics and treatment strategies of patients with retroperitoneal schwannomas adjacent to important abdominal vessels.Case Presentation: A total of three patients with retroperitoneal schwannoma immediately adjacent to important blood vessels in the abdominal cavity underwent successful surgical resection. They all had symptoms of abdominal pain and discomfort, two cases underwent three-dimensional reconstruction. There were no serious complications such as peripheral blood vessels and organ damage in all three cases. One case had chyle leakage after surgery, conservative treatment was successfully discharged.Conclusions: Retroperitoneal schwannomas immediately adjacent to important abdominal vessels have unique clinical characteristics. Preoperative three-dimensional reconstruction can fully show the local vascular relationship of the tumor, which is conducive to surgical planning and risk assessment. Benign tumors with large size and adjacent complex vessels can still be completely resected by surgery. Laparotomy resection is safe and feasible.

Imaging features of primary renal lymphoma

Background Cases of primary renal lymphoma (PRL) are quite rare and are often mistaken for renal cell carcinoma. Purpose To determine the multislice computed tomography (MSCT) and magnetic resonance imaging (MRI) characteristics of PRL. Materials and Methods Twenty-three patients with PRL were identified by CT and MRI, and their tumor characteristics were assessed. Results Tumors exhibited single or multifocal nodules (n = 19) and diffuse renal enlargement (n = 4). Twenty-two tumors exhibited an infiltrative appearance. There was no evidence of calcification in any of the cases. Twenty-one tumors displaced or wrapped around abdominal vessels rather than encasing them. Enlarged retroperitoneal nodes were observed in three cases. Neither extension into the venous system nor distant metastasis was found. Tumor enhancement was of low attenuation compared with that of normal renal cortex and medulla ( P < 0.05). PRL was isointense on T1-weighted imaging, slightly hypointense on T2-weighted imaging and hyperintense on diffusion-weighted imaging. Twenty-two patients exhibited biopsy-confirmed PRN. There were four, 12, and seven cases of low-grade, intermediate-grade, and high-grade tumors, respectively. Patient were followed up over 16 to 166 months. Six patients died within three years and five patients died within five years. Conclusion Infiltrative appearance and tumor displacement or extension around abdominal vessels rather than vessel encasement are common findings on CT or MRI imaging and may suggest a diagnosis of PRL.

Temporal and comparative analysis between abdomen dissection methods for aorto-caval exposure

Introduction: The systemic exposure of the Human Body or dissection is considered of utmost importance by the study of abdominal vasculature, due to its applicability in Clinical Medicine, Surgery, Radiology and Pathology. The specialized literature does not mention comparative studies of time spent for execution of different dissection methods in order to prioritize the quickest method, and thereby, optimize academic or professional training in Anatomy or Emergency Surgery. The present research aimed at comparing the time required to perform dissection methods that prioritize the exposure of large abdominal vessels. Materials and Methods: Embalmed bodies of six adults were considered for execution (by the same professional) of Cattell-Braasch and Mattox maneuvers by manual blunt dissection or surgical instruments. Discussion: We evaluated the time spent for satisfactory completion of both maneuvers as well as for proper exposure of the large abdominal vessels, with statistical analysis using the Mann-Whitnney test with a 5% significance level. Conclusion: The Cattell-Braasch maneuver, blunt dissection or surgical instruments are similarly quick for folding of the cecum and adequate exposure of the inferior vena cava. For Mattox maneuver, blunt dissection is quicker compared to that performed by surgical instruments for the folding of the sigmoid colon and large aortic exposure.