Laparoscopic resection of retroperitoneal schwannoma : Summary of diagnosis, surgical and pathologic outcomes

Myung Jae Jung, Dr, Ho kyoung Hwang, Dr, Chang Moo Kang, Dr, Woo Jung Lee, Pf. Yonsei University Severance Hospital.

Introduction: Schwannomas are known to arise from neural sheath Schwann cells. It is usually found in head and neck area. However, the incidence of retroperitoneal schwannoma is very rare (1.5~3%).

Objective: We reviewed 9 cases of retroperitoneal schwannoma that were successfully excised by laparoscopic surgery.
Method: From Jan 2007 to July 2013, nine patients underwent surgical resection for retroperitoneal schwannoma in Yonsei University Severance hospital. We reviewed all patient`s medical records for diagnosis, management and immunohistochemistry findings.

Results: The median age was 48 years old (26 to 67) and 7 patients (77.8%) were Female. In 6 patients, tumors were identified incidentally by routine medical checkup. 3 patients were presented with clinical symptoms, such as back pain, abdominal discomfort and anemia.All patients were diagnosed by image study not by histologic examination before operation. Tumor sized ranged from 1.5 to 10.0 cm (median, 4.6cm. Complete resection was achieved in all patients. Mean post-operative day until discharge was 3.6 days(2 to 6 days) and mean operation time and intra-operative bleeding amount were 206 minute and 88.9cc.

No intra-operative transfusion was needed and post-operative complication and mortality were not occurred in all patients. There was no recurrence during follow-up period (median 19 months, range 1 to 45 months). All patients who checked immunohistochemistry examination showed S-100 protein positive.

Conclusion: Even small number of cases, laparoscopic resection is feasible and effective with favorable perioperative surgical outcomes in treating retroperitoneal Schwannoma.

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