Retroperitoneal Schwannomas: Experiences at Taipei Veterans General Hospital
摘要
OBJECTIVEl: To evaluate the clinical characteristics of primary retroperitoneal schwanomas. MATERIALS AND METHODS: Medical records of patients with primary retroperitoneal schwannoma were retrospectively reviewed. Clinical manifestations, diagnoses, treatments and outcomes of the patients were analyzed. RESULTS: From 1960 to 2000, there were 764 cases of schwannomas diagnosed histopathologically at Taipei Veterans General hospital. Of these, 17 cases were primary retroperitoneal schwannomas. Sixteen cases (94%) were benign schwanomas, and 1 (6%) was malignant. The mean age at diagnosis was 56.4 (range 21-80) years. The mean follow-up period was 51.3 (range2-169) months. Nine patients (52.9%) were male, and 8were female. The most common presentations were distension and pain over the tumor site which were experienced in 8 patients (47%). Eight patients (47.1%) had negative physical findings, and 7 (41.2%) had a self-palpable mass. Imaging studies including sonography, computerized tomography (CT) scanning, and magnetic resonance imaging (MRI) provided high accuracy for detecting and accessing the tumor masses. Seven (41.2%) tumors were located in the pelvis, 4 (23.5%) in the perirenal area, 4 (23.5%) in nerve roots and 2 (12.3%) in the adrenal gland. Sixteen patients (94.1%) only underwent surgery for tumor resection while the other patient with the malignant retroperitoneal schwannoma also received only local radiotherapy due to schwannomatosis. Two surgical complications (12.5%) of nerve injury were noted. The overall 5-year cumulative survival rate was 87.84%; only the patient with the malignant retroperitoneal schwannoma died 1 month after diagnosis. Local tumor recurrence was noted in 2 patients 911.8%) by a follow-up CT scan and MRI at 20 and 24 months after surgery, respectively. Both patients received conservative treatment for the recurrent tumor. CONCLUSIONS: The results of this retrospective study show that local distension and pain are themost common p