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Non-functioning retroperitoneal abdominal schwannoma
Sherif Sultan1,2, Nora Barrett3, Stephanie Curran4
1Department of Vascular and Endovascular Surgery, Western Vascular Institute, Galway, Ireland sherif.sultan@hse.ie.
BMJ Case Reports
|June 20, 2020
Summary
Non-functioning retroperitoneal abdominal schwannoma (NRS) is rare. This case highlights the importance of hormonal assays to rule out functional paraganglioma, even with negative initial biochemical tests, before surgical intervention.
Area of Science:
- Oncology
- Surgical Oncology
- Endocrinology
Background:
- Non-functioning retroperitoneal abdominal schwannoma (NRS) is an exceptionally rare tumor, with fewer than 150 cases documented globally.
- Accurate diagnosis is critical, as misidentification could lead to surgical complications if the tumor is a functional retroperitoneal paraganglioma, which can cause a dangerous catecholamine surge.
Observation:
- A 42-year-old woman presented with symptoms including headache, night sweats, and abdominal discomfort.
- Imaging revealed a retroperitoneal mass adjacent to the aorta and inferior vena cava.
- Initial hormonal assays (metanephrines and normetanephrines in blood and urine) were negative.
Findings:
- Despite negative biochemical testing, the patient underwent successful surgical resection of the retroperitoneal mass.
- The surgical approach was laparotomy due to the mass's complex location, which posed increased risks for laparoscopic resection.
Implications:
- This case underscores the necessity of comprehensive diagnostic evaluation for retroperitoneal masses, including considering functional tumors even with initially negative hormonal assays.
- It emphasizes the importance of surgical planning based on tumor location and potential risks, favoring open laparotomy when necessary for patient safety.
- Further research into the diagnostic nuances of rare retroperitoneal tumors like NRS is warranted to refine management strategies.
