[Resection of a retroperitoneal schwannoma by a combined approach].
OBJECTIVE
We report a remarkable case of retroperitoneal schwannoma with significant spinal growth illustrating the effectiveness of a combined surgical approach.


METHODS
A 41-year-old man presented with a long history of back pain and unexplained weight loss. An abdominal mass was found in the right upper quadrant. The CT-scan revealed a partially cystic lesion located in the right psoas muscle. Spinal extension was noticed through the L1-L2 neural foramen. MRI better showed the wide rostro-caudal extension in the spinal canal.


RESULTS
Bilateral L1 and L2 laminectomy was performed to remove the spinal portion of the tumor. It was extradural but attached to the dura. The roots were not infiltrated. The retroperitoneal mass was removed by an anterior transperitoneal approach. The histological examination did not reveal criteria of malignancy.


CONCLUSIONS
Retroperitoneal schwannomas are rare and their preoperative diagnosis remains difficult. In case of significant spinal growth, a combined surgical exposure should be preferred to allow total removal of the lesion and control of the neurological structures.
Pollo
C
C
Service de Neurochirurgie, Hôpital de Sion-Hérens-Conthey, Sion, Suisse. claudio.pollo@chuv.hospvd.ch
Richard
A
A
De Preux
J
J
D000328:Adult; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures; D012186:Retroperitoneal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013116:Spinal Cord / Q000473:pathology; D013126:Spinal Nerve Roots / Q000473:pathology; D014057:Tomography, X-Ray Computed