Schwannoma masquerading as metastatic retrocaval lymph node in a patient with incidental gall bladder cancer: a case report and review of literature
DOI:
https://doi.org/10.18203/2349-2902.isj20253036Keywords:
Retroperitoneal schwannoma, Schwannoma, Masquerade, Retroperitoneal lymph node, Retroperitoneal mass, Incidental gall bladder cancer, Metastatic lymph nodeAbstract
Schwannomas are rare benign neoplasms that arise from neural sheath Schwann cells. Their presence in retroperitoneum can mimic other differential diagnosis especially in the setting of a co-existing malignancy. A 31-year-old lady without comorbidities presented with a diagnosis of incidental Gall bladder cancer diagnosed elsewhere. Upon further evaluation, she was found to have a retrocaval mass resembling a metastatic necrotic Lymph node on Contrast Enhanced Computed Tomography (CECT) scan of the abdomen with no evidence of disease elsewhere. Due to the unusual location, mass was biopsied which was inconclusive. Surgical excision of the same was done during Revision cholecystectomy and Final histopathology report revealed it to be a benign Schwannoma. Retroperitoneal Schwannoma with degenerative changes can be a great mimicker of metastatic necrotic malignant lymph node and create diagnostic confusion. With prompt suspicion in mind and clinicoradiological correlation, it is imperative to make informed surgical decisions to avoid erroneous diagnoses that could lead to over treatment. This case underscores the importance of being aware of the differential diagnoses and the need for proper surgical resection of schwannomas to prevent recurrence and ensure complete treatment. Simultaneously, it emphasizes the importance of not compromising the management of the primary neoplasm, in this case, gallbladder cancer.
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Shelat VG, Li K, Naik S, Ng CY, Rao N, Rao J, et al. Abdominal schwannomas: case report with literature review. International Surg. 2013;98(3):214-8. DOI: https://doi.org/10.9738/INTSURG-D-13-00019.1
Okada N, Hirooka Y, Itoh A, Hashimoto S, Niwa K, Ishikawa H, et al. Retroperitoneal neurilemoma diagnosed by EUS-guided FNA. Gastroint Endos. 2003;57(6):790-2. DOI: https://doi.org/10.1067/mge.2003.216
Shih YC, Chen YL, Fang HY, Wu CY, Lin YC, Lin YM. Schwannoma mimicking liver tumor. Thor Cardiovas Surg. 2009;57(7):436-9. DOI: https://doi.org/10.1055/s-2008-1038984
Kishi Y, Kajiwara S, Seta S, Kawauchi N, Suzuki T, Sasaki K. Retroperitoneal schwannoma misdiagnosed as a psoas abscess: report of a case. Surg Today. 2002;32:849-52. DOI: https://doi.org/10.1007/s005950200166
Jindal T, Mukherjee S, Kamal MR, Sharma RK, Ghosh N, Mandal SN, Das AK, Karmakar D. Cystic schwannoma of the pelvis. The Ann Roy Coll Surg England. 2013;95(1):1-2. DOI: https://doi.org/10.1308/003588413X13511609956697
Choi JH, Yoo KH, Lee DG, Min GE, Kim GY, Choi TS. A case of incidental schwannoma mimicking necrotic metastatic lymph node from bladder cancer. Medicina. 2021;57(7):728. DOI: https://doi.org/10.3390/medicina57070728
Rha SE, Byun JY, Jung SE, Chun HJ, Lee HG, Lee JM. Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiograph. 2003;23(1):29-43. DOI: https://doi.org/10.1148/rg.231025050
Cury J, Coelho RF, Srougi M. Retroperitoneal schwannoma: case series and literature review. Clinics. 2007;62:359-62. DOI: https://doi.org/10.1590/S1807-59322007000300024
Li Q, Gao C, Juzi JT, Hao X. Analysis of 82 cases of retroperitoneal schwannoma. ANZ J Surg. 2007;77(4):237-40. DOI: https://doi.org/10.1111/j.1445-2197.2007.04025.x
Ito M, Mishima Y, Sato T. An anatomical study of the lymphatic drainage of the gallbladder. Surg Radiol Anat. 1991;13(2):89-104. DOI: https://doi.org/10.1007/BF01623880
Lin HT, Liu GJ, Wu D, Lou JY. Metastasis of primary gallbladder carcinoma in lymph node and liver. World J Gastroenterol. 2005;11(5):748. DOI: https://doi.org/10.3748/wjg.v11.i5.748
Cohen LM, Schwartz AM, Rockoff SD. Benign schwannomas: pathologic basis for CT inhomogeneities. American J Roentgenol. 1986;147(1):141-3. DOI: https://doi.org/10.2214/ajr.147.1.141
Woodruff JM, Selig AM, Crowley K, Allen PW. Schwannoma (Neurilemoma) with malignant transformation a rare, distinctive peripheral nerve tumor. American J Surg Pathol. 1994;18(9):882-95. DOI: https://doi.org/10.1097/00000478-199409000-00003
Zhang SQ, Wu S, Yao K, Dong P, Li YH, Zhang ZL, et al. Retroperitoneal schwannoma mimicking metastatic seminoma: case report and literature review. Chinese J Cancer. 2013;32(3):149. DOI: https://doi.org/10.5732/cjc.012.10110
Aran T, Guven S, Gocer S, Ersoz S, Bozkaya H. Large retroperitoneal schwannoma mimicking ovarian carcinoma: case report and literature review. Eur J Gynaecol Oncol. 2009;30(4):446-8.
Alguraan Z, Agcaoglu O, El-Hayek K, Hamrahian AH, Siperstein A, Berber E. Retroperitoneal masses mimicking adrenal tumors. Endocrine practice. 2012;18(3):335-41. DOI: https://doi.org/10.4158/EP11240.OR
Shabana W, Raslan W, Hassan S, Al-Tartir T. Schwannoma masquerading as adrenocortical tumor: a case report and review of literature. Urol Case Rep. 2019;26:100926. DOI: https://doi.org/10.1016/j.eucr.2019.100926
Bohlok A, El Khoury M, Bormans A, Galdon MG, Vouche M, El Nakadi I, et al. Schwannoma of the colon and rectum: a systematic literature review. World J Surg Oncol. 2018;16:1-2. DOI: https://doi.org/10.1186/s12957-018-1427-1
Liu LN, Xu HX, Zheng SG, Sun LP, Guo LH, Wu J. Solitary schwannoma of the gallbladder: a case report and literature review. World J Gastroenterol. 2014;20(21):6685. DOI: https://doi.org/10.3748/wjg.v20.i21.6685
Kerwan A, Al-Jabir A, Mathew G, Sohrabi C, Rashid R, Franchi T, et al. Revised Surgical CAse REport (SCARE) guideline: An update for the age of Artificial Intelligence. Premier J Sci. 2025:10;100079.
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