1
|
Zhou S, Wan S, Li L, Dong W, Ma X, Chu H, Zhong Y. Rare retroperitoneal giant sacral schwannoma: A case report. Oncol Lett 2024; 27:261. [PMID: 38646494 PMCID: PMC11027106 DOI: 10.3892/ol.2024.14394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/15/2024] [Indexed: 04/23/2024] Open
Abstract
Schwannomas localized in the sacrum are relatively infrequent, accounting for 1-5% of all spinal axis schwannomas; they present with vague symptoms or are symptomless, so often grow to a considerable size before detection. Sacral schwannomas occasionally present with enormous dimensions, and these tumors are termed giant sacral schwannomas. However, their surgical removal is challenging owing to an abundant vascularity. The present study retrospectively analyzed the clinical and follow-up data of a patient with a giant sacral schwannoma. The patient experienced numbness in the left buttock and lower extremity, with radiating pain in the sole of the foot that had persisted for 3 years. A presacral mass was found by computed tomography examination 6 months after the stool had become thin. A tumor resection was performed using the anterior abdominal approach. A schwannoma was diagnosed by postoperative pathology. The postoperative course was uneventful, with the complete resolution of symptoms during the 21-month clinical follow-up. Overall, the present study reports the case of a giant sacral schwannoma with pelvic pain that was resected without complications and also discusses its successful management. Additionally, the study presents a systematic review of the literature. We consider that the surgical treatment of giant sacral schwannomas with piecemeal subtotal excision can achieve good outcomes, avoiding unnecessary neurological deficits.
Collapse
Affiliation(s)
- Shunchang Zhou
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Shenyi Wan
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Liang Li
- Department of Radiology, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Wei Dong
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Xuhui Ma
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Haibo Chu
- Department of General Surgery, Jiaozhou Branch of Shanghai East Hospital, Tongji University, Qingdao, Shandong 266300, P.R. China
| | - Yuxu Zhong
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Institute of Pharmacology and Toxicology, Beijing 100850, P.R. China
| |
Collapse
|
2
|
Uotani K, Yamauchi T, Sano K, Sonobe H, Fujiwara Y, Maste PS, Sonawane S, Tanaka M. O-arm Navigation-Guided Surgical Resection and Posterior Fixation for a Large Sacral Schwannoma. Acta Med Okayama 2021; 75:647-652. [PMID: 34703049 DOI: 10.18926/amo/62779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sacral schwannoma is a rare tumor with relatively few symptoms; it thus tends to be large at diagnosis and is challenging to treat surgically. We present the case of a 12-year-old girl with a large sacral schwannoma that was successfully surgically resected using O-arm navigation in a two-stage operation. First, we performed tumor resection from the posterior aspect with assisted O-arm navigation. One week later, resection from the anterior aspect was conducted with posterior spinopelvic fixation and fibula graft. We performed partial resection of the tumor from the anterior and posterior aspects as much as possible. O-arm navigation contributed to precise and safe tumor resection and implant insertion.
Collapse
Affiliation(s)
- Koji Uotani
- Department of Orthopaedic Surgery, Okayama Rosai Hospital
| | - Taro Yamauchi
- Department of Orthopaedic Surgery, Okayama Rosai Hospital
| | - Keisuke Sano
- Department of Orthopaedic Surgery, Ehime Rehabilitation Center for children
| | | | | | | | | | - Masato Tanaka
- Department of Orthopaedic Surgery, Okayama Rosai Hospital
| |
Collapse
|
3
|
Konovalov NA, Korolishin VA, Solenkova AV, Nikitenkova IV, Nikitin KV, Asyutin DS, Martynova MA, Timonin SY, Zakirov BA, Kaprovoy SV, Batyrov AA. [Resection of a giant sacral schwannoma: case report and literature review]. Zh Vopr Neirokhir Im N N Burdenko 2019; 83:101-108. [PMID: 31166324 DOI: 10.17116/neiro201983021101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Neurogenic sacral tumors are extremely rare. In most reported cases, this pathology was associated with neurofibromatosis. Sacral tumors manifest themselves at the stage when the neoplasm volume becomes giant, but these manifestations usually go unnoticed for the patient. Surgical approach to the sacral region is extremely challenging; intimate proximity of tumor capsule to vital organs, vessels, and nerves makes radical surgical treatment of these neoplasms rather difficult. A case report of radical resection of a schwannoma that was destroying the sacrum and continued to grow after radiotherapy is presented in this article.
Collapse
Affiliation(s)
| | | | | | | | - K V Nikitin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - D S Asyutin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | | | - S Yu Timonin
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - B A Zakirov
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - S V Kaprovoy
- Burdenko Neurosurgical Institute, Moscow, Russia
| | - A A Batyrov
- Burdenko Neurosurgical Institute, Moscow, Russia
| |
Collapse
|