Authors :
Dr. Rajesh K N; Dr. Anvesh A; Dr. Manjunath A P; Dr. Guruprasad B
Volume/Issue :
Volume 8 - 2023, Issue 3 - March
Google Scholar :
https://bit.ly/3TmGbDi
Scribd :
https://bit.ly/3m8qbbX
DOI :
https://doi.org/10.5281/zenodo.7800620
Abstract :
Schwannomas are peripheral nerve
sheath tumors arising from Schwann cells. They are
usually found in head and neck, mediastinum and
extremities but rarely found in pelvis. Pelvic
schwannomas have a slow growth rate, remain
asymptomatic and get incidentally detected.
Materials and Methods: A 54 year old male presented
with right loin pain and burning micturation since 2
days. Ultrasonography showed right mid ureteric
calculus with a thick walled cystic swelling in
presacral region. Digital rectal examination revealed
a firm, fixed posterior extra rectal mass. The upper
limit of the mass could not be reached. Patient was
evaluated and on emergency basis Ureterorenoscopy
with right sided DJ stenting was done. CE-MRI of
pelvis showed a large well defined T1 hypointense,
T2 iso-hyperintense solid cystic lesion in presacral
region. Mass effect over rectum and urinary bladder
anteriorly. Posteriorly, abutting the sacrum and in
close relation with right S3 exiting nerve root –
F/S/O Schwannoma. Intraoperatively, cystic
swelling noted in presacral region measuring
12×10cm. Entire tumor was excised and its origin
from nerve root identified and excised without
injuring it.
Results: Histopathological report revealed benign
nerve sheath tumor composed of Schwann cells with
focal Verocay body formation. Immunohistology
confirmed Schwannoma with diffuse positivity of S100 protein in the cytoplasm of tumor cells.
Conclusion: Schwannomas with degenerative
changes like cyst formation, calcification and
hemorrhage are called as ‘Ancient Schwannomas’.
MRI is the most preferred imaging technique.
Complete surgical excision remains the treatment of
choice. Recurrence rate is usually low with good
prognosis.
Keywords :
Schwannoma, Nerve Sheath, Schwann Cells.
Schwannomas are peripheral nerve
sheath tumors arising from Schwann cells. They are
usually found in head and neck, mediastinum and
extremities but rarely found in pelvis. Pelvic
schwannomas have a slow growth rate, remain
asymptomatic and get incidentally detected.
Materials and Methods: A 54 year old male presented
with right loin pain and burning micturation since 2
days. Ultrasonography showed right mid ureteric
calculus with a thick walled cystic swelling in
presacral region. Digital rectal examination revealed
a firm, fixed posterior extra rectal mass. The upper
limit of the mass could not be reached. Patient was
evaluated and on emergency basis Ureterorenoscopy
with right sided DJ stenting was done. CE-MRI of
pelvis showed a large well defined T1 hypointense,
T2 iso-hyperintense solid cystic lesion in presacral
region. Mass effect over rectum and urinary bladder
anteriorly. Posteriorly, abutting the sacrum and in
close relation with right S3 exiting nerve root –
F/S/O Schwannoma. Intraoperatively, cystic
swelling noted in presacral region measuring
12×10cm. Entire tumor was excised and its origin
from nerve root identified and excised without
injuring it.
Results: Histopathological report revealed benign
nerve sheath tumor composed of Schwann cells with
focal Verocay body formation. Immunohistology
confirmed Schwannoma with diffuse positivity of S100 protein in the cytoplasm of tumor cells.
Conclusion: Schwannomas with degenerative
changes like cyst formation, calcification and
hemorrhage are called as ‘Ancient Schwannomas’.
MRI is the most preferred imaging technique.
Complete surgical excision remains the treatment of
choice. Recurrence rate is usually low with good
prognosis.
Keywords :
Schwannoma, Nerve Sheath, Schwann Cells.
