Erdal UYSAL, Reşat KERVANCIOĞLU, Göktürk MARALCAN, Mehmet SÖKÜCÜ, Hasan BAKIR, Türkay KIRDAK

Dev retroperitoneal ancient schwannoma: Oldukça nadir bir lokalizasyonda, nadir tipte bir schwannoma

Schwannoma’lar, sinir kılıflarındaki schwann hücrelerinden köken alan tümörlerdir. Vücudun pek çok bölgesinden kaynaklanabilirler. En sık olarak baş boyun bölgesinde görülürler. Retroperitoneal bölgede ise oldukça nadirdirler Ancient schwannoma ise oldukça az görülen bir subtipdir. Bu vaka sunumunda; nadir görülen, kistik dejenerasyon göstermiş ve dev boyutlara ulaşmış retroperitoneal ancient schwannoma olgusu sunulmuştur. Kırk dokuz yaşında kadın hasta, merkezimize 7yıldır karında giderek büyüyen şişlik ve sertlik şikayeti ile başvurdu. Fizik muayenede karnın sağ tarafında; subkostal alandan inguinal bölgeye kadar uzanan sert, mobilitesi olmayan ve uzun ekseni yaklaşık 30cm olan kitle palpe edildi. Oral ve intravenöz kontrastlı abdominopelvik tomografide enkapsüle, kistik komponentler de içeren solid retroperitoneal kitle saptandı. Kitlenin boyutu 28x20x12 cm boyutlarında idi. Kitlenin total eksizyonu planlandı. Kitle, kapsülü ile birlikte total olarak çıkarıldı. Patolojik incelemede yaygın multifokal kistik dejenerasyon gösteren benign karakterli ancient schwannoma tespit edildi. İmmünohistokimyasal boyamada S100 pozitif bulundu. Hasta ameliyat sonrası 5. günde taburcu edildi. Schwannomalar yavaş seyirli benign tümörlerdir. Belirti vermeden dev boyutlara ulaşabilirler. Shwannomalar olukça nadir olarak retroperitoneal bölgeye yerleşirler. Ancient schwannomalar, schwannomaların nadir görülen bir subtipidir.

Giant retroperitoneal ancient schwannoma: An unusual schwannoma type in the rarest localization

Schwannomas are tumors originating from Schwann cells in the nerve sheath. Although they can appear on many parts of thebody, they occur most frequently in the head and neck. Furthermore, they are very rarely seen in the retroperitoneal region. Ancientschwannoma is a sub-type of schwannomas that is quite rare. In this study, the case of a retroperitoneal ancient schwannoma,which showed cystic degeneration and reached gigantic sizes, is presented. A forty-nine-year-old female patient was admittedto our center with complaints of growing abdominal distention and stiffness for 7 years. In the physical examination, a non-mobileand stiff mass that was approximately 30 cm along its longest axis and extended from the subcostal area to the inguinal regionwas detected on the right side of the abdomen. A solid retroperitoneal mass containing encapsulated and cystic components wasconfirmed in the oral and intravenous contrasted abdominopelvic tomography. The size of the mass was 28×20×12 cm, and atotal excision of the mass was planned. The mass was excised together with the capsule. In the pathological examination, ancientschwannoma, which showed widespread multifocal cystic degeneration with benign characteristic, was found. In the immunohistochemicalstaining, S100 was found to be positive. The patient was discharged on the 5th postoperative day. Schwannomasare slowly progressive benign tumors that can reach a large size without any symptoms and rarely settle in the retroperitonealregion. Ancient schwannomas are also a rarely seen sub-type of schwannomas. In this study, the case of a retroperitoneal ancientschwannoma, which showed cystic degeneration and reached gigantic sizes, is presented.

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