Kalagi Dana, Bakir Mohammed, Alfarra Mohammad, Aborayya Alaa, Anwar Ihab
Alfaisal University, College of Medicine, Riyadh, Saudi Arabia; Department of Surgery, Section of General and Oncology Surgery, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia.
Alfaisal University, College of Medicine, Riyadh, Saudi Arabia.
Int J Surg Case Rep. 2019;61:165-168. doi: 10.1016/j.ijscr.2019.07.042. Epub 2019 Jul 22.
Schwannomas are benign tumors that arise from the Schwann cells of nerve fibers. They commonly occur in the head and neck, mediastinum and extremities. However, they are extremely rare to be found in the pelvis.
We report two cases of pelvic presacral schwannomas found in our hospital. The first case is a 50 years old lady who was seen in the outpatient clinic complaining of pelvic heaviness. Investigations were done including Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) which showed a solid mass in the presacral area. Biopsy was taken, and results came back as schwannoma. The patient underwent exploratory laparotomy and total tumor resection. The second case is a 19 years old gentleman who was referred from a local hospital to our hospital for further evaluation of an asymptomatic left retroperitoneal pelvic mass. The mass was found incidentally after a Road Traffic Accident. The patient underwent exploratory laparotomy and total tumor resection. In the two cases, specimen histopathology report came back positive for schwannoma and patients were doing fine in the post-operative period with no signs of recurrence till this date.
Due to the few cases in the literature, the diagnosis of presacral schwannoma is challenging. Some patients presented with vague symptoms like pelvic heaviness as seen with the patient in the first case, and some presented completely asymptomatic as seen with the patient in the second case. In symptomatic and asymptomatic cases, surgical excision is the mainstay of treatment of these tumors.
施万细胞瘤是起源于神经纤维施万细胞的良性肿瘤。它们通常发生在头颈部、纵隔和四肢。然而，在骨盆中发现极为罕见。
我们报告我院发现的两例骶前施万细胞瘤。第一例是一名50岁女性，在门诊就诊时主诉盆腔坠胀。进行了包括计算机断层扫描（CT）和磁共振成像（MRI）在内的检查，结果显示骶前区域有一个实性肿块。进行了活检病理结果回报为施万细胞瘤。患者接受了剖腹探查和肿瘤全切术。第二例是一名19岁男性，从当地医院转诊至我院，以进一步评估左腹膜后盆腔无症状肿块。该肿块是在一次道路交通事故后偶然发现的。患者接受了剖腹探查和肿瘤全切术。两例患者标本的组织病理学报告均显示施万细胞瘤阳性，术后患者恢复良好，至今无复发迹象。
由于文献报道的病例较少，骶前施万细胞瘤的诊断具有挑战性。一些患者表现出如第一例患者那样的盆腔坠胀等模糊症状，而另一些患者如第二例患者则完全无症状。对于有症状和无症状的病例，手术切除是这些肿瘤的主要治疗方法。
