Retroperitoneal malignant nerve sheath tumor

Abstract

A 72-year-old white female presented with 3-week history of increasing abdominal pain, bilateral leg swelling, decreasing urine output and shortness of breath. She started to have worsening bilateral leg edema right greater than left. She had Doppler ultrasound of her legs which was negative for deep vein thrombosis. She was prescribed furosemide two times daily with minimal improvement in swelling. A few weeks later, she started to have abdominal pain and shortness of breath. Abdominal pain was new onset, dull, right-sided with no radiation or aggravating relieving factors. She noticed abdominal mass incidentally while taking shower which became more apparent on bending. Her past medical history was significant for hypertension, coronary artery disease with bare-metal stent to the right middle coronary artery 9 years ago and insulin-dependent diabetes mellitus. On arrival, her vitals were 36.4°C, 100/68 mm Hg, 97 per min, 31 per min respiratory rate and body mass index 46 kg/m2. Abdominal examination was notable for a right-sided antero-lateral mass with irregular borders …