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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
PubMed
Summary
This summary is machine-generated.

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.

Keywords:
pathologysurgeryvascular surgery

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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.