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MINERVA ORTOPEDICA E TRAUMATOLOGICA

A Journal on Orthopedics and Traumatology


Official Journal of the Piedmontese-Ligurian-Lombard Society of Orthopedics and Traumatology
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Minerva Ortopedica e Traumatologica 2008 April;59(2):115-20

language: Italian

Ileopsoas schwannoma with lii severe osteolisys

Gino G. C. 1, Boffano M. 2, Albertini U. 1, Tosco P. 3, Carannante G. 4, Bertoldo U. 1, Brach del Prever E. M. 1

1 Unità Complessa di Chirurgia Oncologica e Ricostruttiva Dipartimento di Ortopedia e Traumatologia AO CTO/Maria Adelaide, Torino, Torino, Italia
2 Scuola di Specializzazione in Ortopedia e Traumatologia Università degli Studi di Torino, Torino, Italia
3 Dipartimento di Ortopedia e Traumatologia AO CTO/Maria Adelaide, Torino, Torino, Italia
4 Unità Chirurgia Vertebrale Dipartimento di Ortopedia e Traumatologia AO CTO/Maria Adelaide, Torino, Torino, Italia


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Schwannoma is a benign neoplasm, or amar-thoma for some authors, consisting of Schwann cells. The presentation can be asymptomatic or, more frequently, painful due to nerve compression. A retroperitoneal localization, particularly inside the ileopsoas muscle, is very rare. The aim of this article was to define different presentations and treatments for psoas schwannomas through a case report analysis. Authors present the analysis of a case of a schwannoma localized in the ileopsoas muscle surgically treated with en bloc excision, double surgical access and posterior vertebral stabilization. A review of literature was made using Pubmed, Ovid, Scirus; keywords used for the search were: neurinoma, schwannoma, retroperitoneal, psoas, in different combinations. Inclusion criteria for the search were the English, French, Italian language of the articles; no restriction was posed for the type of paper. The diagnosis and treatment of retroperitoneal schwannomas that have grown inside the psoas muscle have been evaluated in 9 case reports, with brief literature reviews. A neurinoma localized in the ileopsoas is a rare neoplasm and diagnosis is often accidental. The surgical approach is invasive and may be performed through laparotomic exploration, or double surgical access, depending on the structures involved; frequently peripheral nervous deficits persist.
Ileopsoas schwannoma treatment is difficult and cannot be standardized; adequate preoperatory staging and treatment in a specialized reference centre are mandatory.

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