A CASE OF NEURILEMMOMA ORGINATED FROM THE INTERCOSTAL NERVE WHICH MADE A RETRACTION OT THE LIVER

Abstract

A case of neurilemmoma originated from the intercostal nerve which made a retraction to the liver in a 63-year-old woman is reported. The patient was seen at the hospital because of right hypochondralgia. Physically, her right chest wall was distended. Ultrasonography and CT scan visualized a tumor about 5cm in diameter which looked like liver tumor in S2. This tumor had a low intensity capsule was enhanced by gadolinium in T1 weighted view, and was high intensity in T5 weighted view by MRI. Right 9th intercostal angiogram revealed tumor vessel at the early arterial phase and tumor stain at the late venous phase. Laparotomy was performed with a diagnosis of primary tumor of the abdominal wall. The tumor arising from the right lateral abdominal wall projected into the abdominal cavity in a shape of hemisphere and buried in the liver S5, forming a retraction. No adhesion to the liver was confirmed. The tumor surrounding peritoneum was resected. The resected specimen was macroscopically white smooth elastic hard mass, 6.0×4.5×4.0cm in size. Microscopically it was neurilemmoma comprized of Antoni type A and type B concomitantory. These has been no sign of recurrence of 4 years after the operation but the patient is strictly followed up on an ambulant basis.