Principles of diagnosis and surgical treatment of patients with retroperitoneal schwannomas

Abstract

Schwannomas are rare tumors that arise from well-differentiated schwannoma cells of peripheral nerve sheaths. Schwannomas are usually benign tumors. However, malignant form of schwannomas may occur, which is associated with high recurrence rate and unfavorable long-term prognosis. Retroperitoneal localization of schwannomas is rare. With a little data available it is difficult to develop a unified approach for preoperative evaluation, surgical treatment and follow-up of patients with retroperitoneal schwannomas. Assessment of malignant potential of tumor before resection is challenging while immunohistochemical analysis of resected specimen allows to clearly define histological type and malignant grade of tumor. Complete resection of retroperitoneal schwannoma is the only treatment option that may provide acceptable long-term results. As most of the retroperitoneal schwannomas are localized in an anatomical complex area there is high risk of combined resection and massive intraoperative blood loss. Choice of optimal operative approach, necessity of sacral and nerve resection depending on the degree of disease extent remains the matter of debates. Benign retroperitoneal schwannomas have favourable prognosis for long-term survival while malignant tumors are associated with high recurrence rate.

Keywords

• retroperitoneal schwannoma
• pelvic schwannoma
• surgical treatment
• prognosis