Retroperitoneal giant schwannoma eroding lumbal vertebra: A case report with a literature review

• Authors: Marija Sakalauskaite , Juozas Stanaitis , Saulius Cepkus , Mindaugas Pleckaitis , Raimundas Lunevicius
• Languages of publication: EN

Abstracts

EN

A huge schwannoma, located in the retroperitoneal space, is found very rarely. The main purpose of this paper is to present the case of a giant retroperitoneal schwannoma which partly invaded L4 vertebral body. The secondary purpose is to summarize the case-report articles on retroperitoneal schwannomas. A circumscribed heterogenic tumour was revealed on transabdominal sonography. It extended into the right retroperitoneal space. CT and MRI revealed a paravertebral tumour in the size of 11 cm × 9 cm, which is causing a partial lysis of L4 vertebral body (15% of vertebral capacity), expanding intravertebral foramen and filling the right retroperitoneal space. A preoperative core needle biopsy was performed and a benign schwannoma was diagnosed. A complete surgical excision of the tumour was achieved by a two-step operation. During the first step, the neurosurgeons made L4 hemilaminectomy, facetectomy and a transverse process resection by posterior extended approach. The general surgeons excised the residual retroperitoneal part of the tumour by midline transabdominal approach 10 days later. The diagnosis of benign schwannoma was verified histochemically. There were no sign of tumour recurrence or spine destabilization at the six-month follow-up. In conclusion, although majority of giant retroperitoneal schwannomas can be completely removed performing one-step operation, a preoperative consideration about rationality of two-step operation should be mandatory when tumour destructs a part of vertebral body. Our case shows that the combined two stage complete surgical excision of a giant retroperitoneal schwannoma, eroding 15% of L4 vertebra’s osseous capacity, is effective and does not have any negative influence on spinal stability.

Keywords

EN

Schwannoma; Neurilemmoma; Retroperitoneal neoplasm; Surgery

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 2
• Pages: 233-244

Dates

published

1 - 6 - 2008

online

9 - 4 - 2008

Contributors

author

Marija Sakalauskaite

• Clinic of Gastroenterology, Nephrourology and Surgery, Center of General Surgery, Vilnius University, LT-04130, Vilnius, Lithuania

author

Juozas Stanaitis

• Clinic of Gastroenterology, Nephrourology and Surgery, Center of General Surgery, Vilnius University, LT-04130, Vilnius, Lithuania

author

Saulius Cepkus

• Clinic of Neurology and Neurosurgery, Vilnius University, LT-04130, Vilnius, Lithuania

author

Mindaugas Pleckaitis

• Department of Pathology, Vilnius University Emergency Hospital, LT-04130, Vilnius, Lithuania

author

Raimundas Lunevicius

• Clinic of Gastroenterology, Nephrourology and Surgery, Center of General Surgery, Vilnius University, LT-04130, Vilnius, Lithuania

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Identifiers

DOI

10.2478/s11536-008-0006-1