A giant presacral schwannoma - Surgical considerations with an illustrative case and review of the literature

巨大骶前神经鞘瘤——手术考量及病例分析和文献综述

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Abstract

BACKGROUND: Giant solitary pelvic schwannomas are rare, benign nerve sheath tumors that can present with diverse neurological and systemic symptoms. Early recognition and careful planning are essential for optimal outcomes. CASE DESCRIPTION: An 18-year-old male presented with low back/left leg pain, constipation, and intermittent left scrotal discomfort. He had previously mistakenly undergone surgery for suspected left testicular torsion. His magnetic resonance imaging revealed a large 10 cm cystic lesion with a solid component arising from the left S2 nerve root. He underwent a two-staged posterior followed by an anterior approach for total excision of a histopathologically confirmed World Health Organization Grade 1 schwannoma. Postoperatively, he retained intact motor, sensory function and preservation of bladder and largely sexual function. CONCLUSION: Pelvic schwannomas may mimic other clinical conditions. Here, total excision of such a lesion was successfully accomplished.

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