A 3-year follow-up case report of rare intramuscular schwannoma of psoas major: Insights into progression and management.

RATIONALE

Intramuscular schwannoma in the psoas major is rare and often asymptomatic in the early stages, leading to a diagnostic delay that averages 2 to 3 years in reported cases. Usually, timely treatment is required when the corresponding symptoms appear. At present, there are few studies on the preoperative follow-up of intramuscular schwannomas of the psoas major.

PATIENT CONCERNS

We report the case of a patient with recurrent lower back pain for 3 years, which was relieved after rest.

DIAGNOSES

In July 2021, computed tomography revealed a tumor in the right psoas muscle, and the size of the tumor increased from 1.5 cm × 1.4 cm × 2.0 cm to 3 cm × 3.2 cm × 4 cm after 2 years and 7 months, with worsening in symptoms. The patient developed frequent swelling and pain in the right waist accompanied by pain and numbness in the right thigh root before surgery.

INTERVENTIONS

Based on the patient's symptoms and the results of lumbar computed tomography and magnetic resonance imaging examinations, right lumbar muscle lateral anterior tumor resection surgery was performed under general anesthesia.

OUTCOMES

After lateral anterior resection of the right lumbar muscle tumor, the patient's symptoms improved significantly, and was discharged the day after surgery.

LESSONS

In subsequent clinical practice, we will pay more attention should be paid to patients with low back pain accompanied by nerve root symptoms. In particular, when anti-inflammatory treatment is ineffective, space-occupying lesions should be excluded. Follow-up may be reasonable, especially for elderly patients whose symptoms are tolerable and have surgical contraindications. More follow-up data are needed to help us understand the development of schwannomas in the psoas muscle. This case is of great significance for understanding the progression of intramuscular schwannomas of the psoas major.