CASE REPORTS   

Minerva Ortopedica e Traumatologica 2008 April;59(2):115-20

Copyright © 2008 EDIZIONI MINERVA MEDICA

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

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.