Laparoscopic Resection of Retroperitoneal Schwannoma: Report of 3 cases

Abstract

Background: Schwannoma is a neoplasm that arises from Schwann cells in the peripheral nerve sheath. They are mainly benign tumors, Ohigashi T et al. reported that only 0.7% is located in the retroperitoneum and these are associated with a higher rate of malignancy. The preoperative diagnosis is a challenge due to its low frequency and the low specificity of imaging studies. Treatment consists of its complete surgical resection, avoiding its rupture since it is associated with local recurrences. The laparoscopic approach presents technical limitations due to the usually large size of these tumors, and few cases of laparoscopic excision have been reported in the world literature to date. Methods: the results of 3 retroperitoneal schwannomas of different location, size and complexity are presented, all resolved laparoscopically by a highly complex laparoscopic surgery team. Results: all surgeries were performed completely laparoscopically, there were no complications associated with the mini-invasive procedure and all the benefits of it were obtained. The anatomopathological and immunohistochemical examination was compatible with schwannomas in all 3 cases. To date, the patients do not present recurrences. Conclusions: although the location, size and relationship with other anatomical structures make the laparoscopic surgical approach difficult, with a well-trained team in laparoscopic surgery, these procedures can be performed safely, without increased morbidity and with all the benefits that mini-invasive procedures provide.