Mazzola Clarisse R, Power Nicholas, Bilsky Mark H, Robert Roger, Guillonneau Bertrand
Urology Service, Surgery Department, Memorial Sloan-Kettering Cancer Center, New York, NY;
Department of Neurosurgery, Memorial Sloan-Kettering Cancer Center, New York, NY;
Can Urol Assoc J. 2014 Mar-Apr;8(3-4):E199-203. doi: 10.5489/cuaj.1734.
Schwannomas are benign nerve sheath tumours most often associated with the cranial nerves and the peripheral nerve system of the neck and extremities. Pelvic schwannomas are rare, with only about 25 cases reported. We report the case of a 34-year-old man referred for worsening pain of 10 years duration involving the right testicle and right penile shaft. Magnetic resonance imaging discovered a well-circumscribed pelvic tumour of 3.2 × 2.8 × 3.2 cm. Considering the possible complications involved in exposing the pudendal nerve during surgical resection, we performed an extensive literature search to aid preoperative planning. The most commonly described surgical approach for pelvic schwannomas has been open median laparotomy with transperitoneal dissection. To our knowledge, pudendal schwannomas have never been described in the literature. However, after considering the location and characteristics of the tumour, we chose laparoscopy because it offers the advantages of better visualization of anatomical structures with minimal invasiveness and faster recovery. At the 3-week follow-up, the patient described a significant decrease in pain and normal neurological and urological examinations.
施万细胞瘤是一种良性神经鞘瘤，最常与颅神经以及颈部和四肢的周围神经系统相关。盆腔施万细胞瘤很罕见，仅有约25例病例报道。我们报告一例34岁男性患者，其因涉及右侧睾丸和右侧阴茎体的长达10年的疼痛加重前来就诊。磁共振成像发现一个大小为3.2×2.8×3.2厘米、边界清晰的盆腔肿瘤。考虑到手术切除过程中暴露阴部神经可能涉及的并发症，我们进行了广泛的文献检索以辅助术前规划。对于盆腔施万细胞瘤，最常描述的手术方法是经腹正中剖腹术及经腹膜后解剖。据我们所知，文献中从未描述过阴部施万细胞瘤。然而，在考虑肿瘤的位置和特征后，我们选择了腹腔镜手术，因为它具有能更好地可视化解剖结构、侵袭性最小且恢复更快的优点。在术后3周的随访中，患者称疼痛明显减轻，神经和泌尿系统检查均正常。
