Giant pelvic schwannoma presenting with increased urinary frequency - Case report

INTRODUCTION AND IMPORTANCE: Schwannoma is a relatively slow-growing and usually benign tumor that consists of myelin-producing Schwann cells. It is most often associated with 8th cranial nerve (vestibular schwanomma) and only rarely presents outside the head and neck. Extremely rarely it occurs as a retroperitoneal mass that can remain asymptomatic until it reaches a size so big that it compresses the adjacent organs and therefore requires surgical intervention. CASE PRESENTATION: We present a case of 58 years old male with a benign pelvic schwannoma, adherent to S1-S2 intervertebral foramen, presenting with increased urinary frequency and treated with surgical en block excision. CLINICAL DISCUSSION: Diagnostic procedure and surgical treatment of giant pelvic schwanomma could be both challenging. Radiologic investigation is essential for preoperative planning and helpful in diagnosis but does not offer a definitive diagnosis of pelvic schwannoma. Definitive diagnosis is therefore based on histological and immunohistochemical analysis of surgically removed specimens. Possible surgical interventions include complete or partial resection, both bearing its risks and advantages in terms of postoperative morbidity. CONCLUSION: Although sometimes challenging, complete surgical resection remains the mainstay of treatment. If possible, it should be performed by en block resection since it provides the best short and long term prognosis for the patient.