Retroperitoneal schwannoma presenting as an ovarian tumor

A mass in the left annexal zone was discovered in a 56-year-old woman at the Department of General Surgery and was diagnosed as ovarian cancer. After the operation the mass appeared histologically to be retroperitoneal leyiomiosarcoma and because of residual disease, confirmed by computed tomography (CT) and nuclear magnetic resonance (NMR), complementary radiotherapy was carried out. Restaging supported the persistence of the tumor and so a second laparotomy was performed with complete tumor resection; the pathologic diagnosis was retroperitoneal benign schwannoma. The importance of careful preoperative imaging, such as echography, CT, NMR, arteriography and urography should be stressed for a correct clinical and surgical approach. Moreover, considering that in some selected clinical cases these tumors could be confused with others deriving from contiguous organs and structures, a different surgical approach may be needed together with dedicated and expert surgeons.

Schwannoma; Ovarian cancer; Sarcoma

[1] Ziparo V., Bocchetti T., Mercantini P., Di Giacomo G., Caleno M.P., Lucandri G.: "Lo schwannoma a localizzazione retroperitoneale". Giorn. Chir., 1996, 17, 399.

[2] Napoletano C., Mutter D., Steib LP., Christmann D., Marescaux J.: "Schwannoma benigno retroperitoneale con lisi vertebrale". Ann. Ital. Chir., 1998, 69, 6.

[3] Pirayesh A., Chee Y., Helliwell T.R., Hershman M.J., Leinster S.J., Fordham M.V., Poston G.J.: "The managment of retroperitoneal soft tissue sarcoma". EJSO, 2001, 27, 491.

[4] Hurley L., Smith J.J., Larsen C.R., Silverman M.L.: "Multiple retroperitoneal schwannoma: a c<1se report and review of the literature". J. Urol., 1994, 151, 413.

[5] Das Gupta T.K., Brasfield R.D., Strong E.W., Hajdu S.I.: "Benign solitary schwannoma (neurilemamas)". Cancer, 1969, 24, 355.

[6] Steers W.D., Hodge G.B., Johnson D.E., Chaitin B.A., Charnsangavej C.: "Benign retroperitoneal neurilemoma without von Recklinghausen's disease: a rare occurrence". J. Urol., 1985, 133, 846.

[7] Weber 0., Zerbib M., Peyret C., Desligneres S., Debre B.: "Schwannome benin retroperitoneal". J. Urologie, 1993, 99, 189.

[8] Morgagni: "Large retroperitoneal lipoma". S. Clin. North. Am., 1934, 14, 601.

[9] Donnelly B.A.: "Primary retroperitoneal tumours: a report of 95 cases and review of the literature". Surg. Gynecol. Obstet., 1946, 83,705.

[10] Johnson A.H., Searls H.H., Grimes 0.F.: "Primary retroperitoneal tumors". Am. J. Surg., 1954, 88, 155.

[11] Cody H.S., Turnbull A.O., Fortner J.G., Haiadu S.l.: "The continuing Challenge of retroperitoneal sarcomas". Cancer, 1981, 47, 2147.

[12] Karakousis C.P., Kontzoglou K., Driscoll D.L.: "Resectability of retroperitoneal sarcomas, a metier of surgical technique?". Eur. J. Surg. Oneal., 1995, 21, 617.

[13] Kilkenny J.W., Bland K.I., Copeland E.M.: "Retroperitoneal sarcoma: the University of Florida experience". J. Am. Coll. Surg., 1996, 182, 329.

[14] Voros D., Theodorou D., Ventouri K. et al.: "Retroperitoneal tumors: do the satellite tumors mean something?". J. Surg. Oneal., 1998, 68, 30.

[15] van Dalen T.: "Management of soft tissue sarcoma in the retroperitoneal space: a population based study in the Netherlands". Utrecht University, 2000.

[16] Schindler O.S., Dixon J.H., Case P.: "Retroperitoneal giant schwannomas: report on two cases and review of the literature". J. Orthopaed. Surg., 2002, 10, 77.

[17] Patocskai E.J., Tabatabain M., Thomas M.J.: "Cellular schwannoma: a rare presacral tumor". Can. J. Surg., 45, 141.

[18] Murat D., Gokhan Y., Mufit C.Y., Semith G., Salih D., Sadettin C., Saffet D.: "Retroperitoneal benign schwannoma: Report of three cases and analysis of clinico-radiologic finding". Tohoku J. Exp. Med., 2003," 200, 93.

[19] Kishi Y., Kajiwara S., Seta S., Kawauchi N., Suzuki T., Sasaki K.: "Retroperitoneal schwannoma misdiagnosed as a psoas abscess". Surg. Today, 2002, 32, 849.

[20] Pittash D., Klose S., Schmith J., Roessner A., Ridwelski K., Lippert H., Lehenrt H.: "Retroperitoneal schwannoma presenting as an adrenal tumor". Esp. Clin. Endocr. Diabetes, 2000, 108, 318.

[21] Daneshmand S., Youssefzadeh D., Chamie K., Boswell W., Wu N., Stein J.P., Boyd S., Skinner D.G.: "Benign retroperitoneal schwannoma: a cese series and review of the literature". Urology, 2003, 62,993.

[22] Calo P.G., Congiu A., Ferreli C., Nicolosi A., Tarquini A.: "I tumori retroperitoneali primitivi. Nostra esperienza". Min. Chir., 1994, 49, 43.

[23] Cavallaio V., Bonaccorso R., Selvaggio C., Mazzone S., Fisichella G., Guardala V.F. et al.: "Inquadramento nosografico dei tumori retroperitoneali". Acta Chir. It., 1991, 47, 820.