14 June 2022 : Case report
[In Press] A 68-Year-Old Woman Presenting with Recurrent Abdominal Pain and a Diagnosis of a Presacral Retroperitoneal Benign Schwannoma that Mimicked an Ovarian Tumor on Pelvic Magnetic Resonance Imagining
Challenging differential diagnosis, Rare diseaseAndreia J. Santos1ABEF, Liliana Duarte1BEF, Sara Catarino Santos1BEF, Carlos Casimiro1E
Am J Case Rep In Press; DOI: 10.12659/AJCR.935985
Available online: 2022-06-14, In Press, Corrected Proof
Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule
Schwannomas are benign tumors and their appearance in the pelvic region is rare and poses a major diagnostic problem. They can be sporadic or associated with genetical syndromes. They have a slow growth rate and may be asymptomatic for many years. Symptoms are usually nonspecific and due to compression of adjacent structures. Abdominal imaging modalities may not be able to differentiate a benign schwannoma from a malignant retroperitoneal tumor. This report is of a case of a 68-year-old woman presenting with recurrent abdominal pain and a diagnosis of a presacral retroperitoneal benign schwannoma that mimicked an ovarian tumor on pelvic magnetic resonance imaging.
The patient had a history of a femoral hernia repair and recurrent lower abdominal pain. Pelvic imaging raised the suspicion of a primary ovarian tumor. The mass appeared to have clear cleavage planes with the surrounding structures, so the patient was proposed for an exploratory laparotomy. Prior to the surgery, an additional pelvic computed tomography (CT) was performed (10 months after the first one), which did not show progression of the disease. The histological examination result was compatible with a benign retroperitoneal schwannoma and not an ovarian tumor.
This report highlights that the diagnosis of retroperitoneal and pelvic masses can be challenging. In women, a primary ovarian tumor should be excluded on imaging and the diagnosis of a benign tumor, such as schwannoma, must be confirmed by histopathology, either preoperatively or following tumor resection.
Keywords: Diagnosis, Differential; Histology; Laparotomy; Neurilemmoma; Pelvic Neoplasms; Retroperitoneal Neoplasms
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