Total resection of presacral giant schwannoma via minimally invasive dorsal approach: illustrative case

BACKGROUND Giant presacral schwannomas are extremely rare in neurosurgery. There are various approaches to the surgical treatment of symptomatic giant presacral schwannomas. The least traumatic is the one-stage surgery with a dorsal approach. OBSERVATIONS The authors describe a case of a 52-year-old male with pain in the sacral region and partial urinary dysfunction. A total tumor resection through a minimally invasive dorsal approach was performed, and anatomical and functional preservation of all sacral nerves with no postoperative complications was achieved. LESSONS The authors have shown the possibility of total tumor resection with a minimally invasive dorsal approach without the development of intra- and postoperative complications. Operative corridors that have been created by a tumor can be used and expanded for a minimally invasive dorsal approach to facilitate resection and minimize tissue disruption.

Giant schwannoma of the left maxillary sinus - a rare case report

BACKGROUND. Polyps, cysts and mucocele are the commonest sinonasal tumors present unilaterally, as well as invasive tumors, such as inverted papillomas and squamous cell carcinomas. On the contrary, Schwannomas are rare lesions found in this area.MATERIAL AND METHODS. We present a case of a 48-year-old female who presented with a 2-year progressive history of left nasal obstruction, cranio-facial fullness sensation and pain, with intermittent epistaxis. The CT scan of the nose and paranasal sinuses showed complete opacification of the entire left nasal cavity and maxillary sinus, causing a deviated nasal septum to the right side.RESULTS. The tumor was completely excised endoscopically without any complication. Histopathology was consistent with that of a schwannoma.CONCLUSION. The diagnosis of sinonasal Schwannomas remains challenging, as it is a rare tumor and sometimes its clinical behaviour and imaging may be misleading. The treatment of choice for paranasal sinus schwannoma is complete excision of the tumor with good prognosis.

Neglected Giant Schwannoma of the Sciatic Nerve – A Case Report

Background : Schwannomas originating from the sciatic nerve are extremely rare and usually present as a pathological mass in palpable examination or pain located in the thigh. Motor and sensory deficits are observed more often when the size of the tumor is more than 40 mm.Case Description : A 19-years- old female patient was referred to Suez Canal University Hospital after 6 years of pain and 2 years of improper management. Neurological examination and MRI of the right thigh was done and revealed huge mass attached to the right sciatic nerve. Surgical excision was undertaken, carefully dissecting the lesion from the sciatic nerve. Histopathological examination revealed the tumor to be a schwannoma. The patient had marked postoperative recovery with marked pain reduction and improved neurological deficits.Conclusions : Schwannomas of the sciatic nerve are rare tumors eccentrically located on the nerve. Although rare, schwannoma of the sciatic nerve should be systematically suspected if thigh mass or persistent sciatica is reported. Surgical excision has good prognosis.