gms | German Medical Science

Objective: Schwanommas of lumbosakral plexus or pelvic peripheral nerves are very rare retroperitoneal tumors. Clinical signs are non specific and they are not to be differed from other abdominal and pelvic masses radiologicaly. Complete removing of the tumor by resection of the nerve is a curative way of treatment but always associated with severe or permanent neurological impairments.

Method: Five cases of retroperitoneal schwanommas were treated at our department. To avoid any neurological postoperative sequels, tumors were resected by preparation of pseudocapsula and resection of carrying fascicle. Laparotomy was performed in cooperation with visceral surgeon to expose the nerve. Follow-up data including neurological outcome and MR-Imaging were collected over 3 years after surgery.

Results: Eighty percent (4 from 5) Patients had no sign of neurological disorder immediately after surgery. One patient reported paresthesia in supplying territory of tumor carrying nerve and without any motoric disturbance. After 3 months, there were no symptoms recorded in this case. All patients were completely free of complains after 3 Months and further follow-up. No residual tumor or relaps could be detected in follow-up MR-Imaging.

Conclusions: Interdisciplinary approach with the help of a visceral surgeon provides an optimal condition for a safe intraneural dissection and complete curative resection by the neurosurgeon; therefore, postoperative neurological disorders can be avoided.