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

Abstract EN

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.