Title: Microsurgical approach to a Presacral Schwannoma with internal iliac venous encasement

Authors: Dr Manasi Rajendra Sawant, Dr Girish Bakhshi, Dr Krishnarao Bhosle, Dr Vernon Velho, Dr Tanay Dhanorkar, Dr Thrilok H.

 DOI: https://dx.doi.org/10.18535/jmscr/v11i2.26

Abstract

Sacral schwannomas are very rare and encompass approximately 1%–5% of spinal schwannomas. Due to their benign nature and slow growth, these tumors are often giant and become difficult to treat. Their removal is a surgical challenge with different strategies reported in the literature. Presacral Schwannomas encased by the internal iliac vein are rare with not many instances of such a case found in literature. This is a case in which the venous encasement was found intraoperatively, following which the surgery was abandoned to avoid excess intraoperative bleeding and to enable further workup like CT scan and CT angiography to delineate the venous component.A multimodal approach was then taken for the excision of the tumour. 

Keywords: Presacral, Schwannoma, Venous encasement, Microsurgery.

References

  1. D. Paulo et al. Surgical management of lumbosacral giant invasive spinal schwannoma: a case report and literature review World Neurosurg (2018)
  2. U.A. Khan et al. Giant sacral schwannoma treated with a 360 approach: a rare case and systematic review of the literature World Neurosurg (2018)
  3. N. Hoarau et al. CT and MR imaging of retroperitoneal schwannoma Diagn. Interv. Imaging (2013)
  4. Samarakoon, L., Weerasekera, A., Sanjeewa, R. et al. Giant presacral schwannoma presenting with constipation: a case report. J Med Case Reports 6285 (2012).
  5. Theodosopoulos, T., Stafyla, V.K., Tsiantoula, P. et al. Special problems encountering surgical management of large retroperitoneal schwannomas. World J Surg Onc 6107 (2008).
  6. Jankowski, Roman, et al. "Presacral schwannoma. Case description." Journal of Medical Science 84.4 (2015): 264-270.

Corresponding Author

Dr Manasi Sawant

Grant Government Medical College and Sir J. J. Group of Hospitals, next to J. J. Flyover, Byculla, Mumbai 400008