title: [A rare cause of constipation: neurinoma of the fourth lumbar nerve. Case report and review of the literature ].
abstract: Constipation is a symptom not to be neglected, especially if the complaint is recent. We report a case where this symptom was the only clinical manifestation of a voluminous retroperitoneal tumor. The tumor was found to be a neurilemmoma of the fourth right lumbar roots, confirmed at pathological examination. Manifestations of extradural neurinomas generally result from compression of neighboring structures. The best preoperative diagnosis approach is magnetic resonance imaging but histology is required for confirmation. The close relations the tumor mass maintains with the unaffected nerve fibers makes resection difficult without postoperative functional consequences. Surgeons discuss the relevance of partial excision in order to preserve the nerve root in case of a benign slow-growing tumor. There does however appear to be a significant recovery of muscle strength even in case of total resection.
authors.affiliation: Service de Médecine Physique et de Réadaptation, Hôpital de Hautepierre, avenue Molière, 67098 Strasbourg Cedex, France. Gross-menguy@chru-strasbourg.fr
authors.forename: Christiane
authors.initials: C
authors.lastname: Gross
authors.forename: Jehan
authors.initials: J
authors.lastname: Lecocq
authors.forename: Marie-Eve
authors.initials: ME
authors.lastname: Isner
authors.forename: Philippe
authors.initials: P
authors.lastname: Vautravers
authors.forename: Christian
authors.initials: C
authors.lastname: Meyer
authors.forename: Pierre
authors.initials: P
authors.lastname: Kehrli
mesh_terms: D000368:Aged; D003248:Constipation / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D009442:Neurilemmoma / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D010524:Peripheral Nervous System Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D013126:Spinal Nerve Roots