title: Benign retroperitoneal schwannoma presenting as colitis: a case report.
abstract: We report a case of a patient presenting with clinical, radiological and endoscopic features of colitis due to a compressive left para-aortic mass. Total open surgical excision was performed, which resulted in complete resolution of colitis. Histopathology and immunohistochemistry revealed benign retroperitoneal schwannoma. These neural sheath tumors rarely occur in the retroperitoneum. They are usually asymptomatic but as they enlarge they may compress adjacent structures, which leads to a wide spectrum of non-specific symptoms, including lumbar pain, headache, secondary hypertension, abdominal pain and renal colicky pain. CT and MR findings show characteristic features, but none are specific. Schwannoma can be isolated sporadic lesions, or associated with schwannomatosis or neurofibromatosis type II (NF2). Although they vary in biological and clinical behavior, their presence is, in nearly every case, due to alterations or absence of the NF2 gene, which is involved in the growth regulation of Schwann cells. Both conditions were excluded by thorough mutation analysis. Diagnosis is based on histopathological examination and immunohistochemistry. Total excision is therapeutic and has a good prognosis. Schwannomatosis and NF2 should be excluded through clinical diagnostic criteria. Genetic testing of NF2 is probably not justified in the presence of a solitary retroperitoneal schwannoma.
authors: Department of Digestive, Laparoscopic and Thoracic Surgery, Brugmann University Hospital, Place Van Gehuchten 4 Brussels 1020, Belgium. garyfass@hotmail.com
authors: Gary
authors: G
authors: Fass
authors: Didier
authors: D
authors: Hossey
authors: Michel
authors: M
authors: Nyst
authors: Dirk
authors: D
authors: Smets
authors: Esmail-Najar
authors: EN
authors: Saligheh
authors: Ruth
authors: R
authors: Duttmann
authors: Kathleen
authors: K
authors: Claes
authors: Pierre-Mendes
authors: PM
authors: da Costa
mesh_terms: D003092:Colitis / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D016515:Genes, Neurofibromatosis 2; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009154:Mutation; D009442:Neurilemmoma / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D012186:Retroperitoneal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome