Presacral Ancient Schwannoma in a Middle-Aged Man- A Rare Entity

Narender Yadav, Ranjana Gupta, Simar Abheet Singh, Puneet Mittal, Shivani Mahendru
2020 Journal of Evolution of Medical and Dental Sciences  
Schwannomas are benign tumours arising from neoplastic transformation of Schwann cells around the nerve fibres. Tumours situated deeply like in retroperitoneum or pelvis are usually asymptomatic and may not be detected. Such long standing tumours may undergo extensive degenerative changes giving rise to ancient schwannomas. [1] Ancient schwannoma is an uncommon variant of schwannomas characterized by extensive degenerative changes and hypocellular areas. Presacral ancient schwannomas are rare
more » ... d most of the reported cases are in females. We describe computed tomography (CT) findings in a case of presacral ancient schwannoma in a 49 year old male patient. P R E SE N T A T I O N O F C A S E A 49-year-old male patient presented with history of pain in umbilical and hypogastric region and constipation for three months. There was no history of urinary complaints, fever or abdominal distension. On examination, abdomen was soft and non-tender. No organomegaly was presented. Per-rectal examination was normal. CT abdomen revealed a well-defined thin walled cystic mass in the presacral location displacing the rectum towards left side. No enhancing solid component or septae were identified. No fat density or calcification was seen. There was no evidence of intrasacral extension or sacral foraminal widening. The lesion was in close proximity to one of the exiting right sacral nerve root suggesting the possibility of nerve sheath tumour. Laparoscopic excision of pelvic mass was done. Complex lobulated cystic mass was seen posterior to the urinary bladder. It was not adherent to the rectum, bladder or sacrum. On histopathology, it was found to be an ancient schwannoma.
doi:10.14260/jemds/2020/153 fatcat:vbgslrwzvzdlzbrsvf2thm7ogu