Limits...
Multiple retroperitoneal schwannomas mimicking adrenal tumors.

Oishi K, Itamoto T, Okimoto S, Nishisaka T - Case Rep Oncol (2012)

Bottom Line: An abdominal computed tomography (CT) scan showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region.The tumors were completely resected.If the tumor increases in size, complete resection should be performed for pathological diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Departments of Surgery and Hiroshima Prefectural Hospital, Hiroshima, Japan.

ABSTRACT
Schwannomas are benign tumors mostly arising from the head and neck. Retroperitoneal schwannomas are rare. Here we report the case of a 68-year-old woman with multiple retroperitoneal schwannomas. An abdominal computed tomography (CT) scan showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region. The patient had regularly undergone CT scans for malignant tumor screening in maintenance dialysis patients. Retrospectively, the 2 tumors had existed in the same regions in previous CT scans and had gradually increased in size. The tumors were completely resected. Pathological diagnosis of both tumors was schwannoma. When a CT scan shows a slowly growing retroperitoneal tumor with a low-density area, schwannoma should be considered. If the tumor increases in size, complete resection should be performed for pathological diagnosis.

No MeSH data available.


Related in: MedlinePlus

CT scan of the abdomen. CT scan of the abdomen with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region (a) and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (d). The 2 tumors could be seen in the same regions on CT scans performed 1 (b, e) and 2 years before (c, f). The tumors had gradually increased in size.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3369249&req=5

Figure 1: CT scan of the abdomen. CT scan of the abdomen with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region (a) and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (d). The 2 tumors could be seen in the same regions on CT scans performed 1 (b, e) and 2 years before (c, f). The tumors had gradually increased in size.

Mentions: A 68-year-old woman who had been receiving hemodialysis for chronic renal failure due to diabetic nephropathy was referred to our hospital for treatment of retroperitoneal tumors. The tumors were detected by one of the abdominal computed tomography (CT) scans that she had regularly undergone. She had been diagnosed with diabetes mellitus at the age of 46 years and had received hemodialysis 3 times a week since she was 59 years of age. She had no history of symptoms of von Recklinghausen disease. There was no family history of cancer. On physical examination at the time of consultation, her body temperature was 36.6°C, blood pressure was 164/80 mm Hg, and pulse rate was 67 beats/min and normal in rhythm. Her height was 160 cm and weight was 67 kg. Hematocrit was 29.7% and hemoglobin level was 9.8 g/dl. In renal function tests, blood urea nitrogen was 35.6 mg/dl and serum creatinine level was 7.16 mg/dl. Serum levels of sodium, potassium and chloride were 136, 6.0 and 101 mEq/l, respectively. Other results of complete blood count and liver function tests performed on admission were within normal ranges. Serum levels of adrenaline, noradrenaline, dopamine, cortisol and aldosterone were within normal ranges (24 pg/ml, 207 IU/l, 5 IU/l, 12.2 μg/dl and 94.1 pg/ml, respectively). Serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were within normal ranges. An abdominal CT scan with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (fig. 1a, d). The patient had been regularly examined by CT scan due to chronic renal failure. Retrospectively, the 2 tumors had never been pointed out by a physician but had existed in the same regions on a CT scan for 1 (fig. 1b, e) and 2 years (fig. 1c, f) before admission. The mean doubling times of the tumors in the left adrenal region and para-aortic region were 422 days and 270 days, respectively. The tumors had gradually increased in size on CT. Preoperative diagnosis was multiple pheochromocytomas or nonfunctioning adrenocortical carcinomas with lymph node metastasis, and she underwent an operation. On exploration of the intra-abdominal cavity, there were 2 tumors. One was in the para-aortic region and the other was in the left adrenal region. The tumor in the left adrenal region had compressed the left normal adrenal gland but was easily detached. Both tumors were completely excised and were diagnosed as schwannomas by microscopic examination of frozen sections.


Multiple retroperitoneal schwannomas mimicking adrenal tumors.

Oishi K, Itamoto T, Okimoto S, Nishisaka T - Case Rep Oncol (2012)

CT scan of the abdomen. CT scan of the abdomen with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region (a) and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (d). The 2 tumors could be seen in the same regions on CT scans performed 1 (b, e) and 2 years before (c, f). The tumors had gradually increased in size.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369249&req=5

Figure 1: CT scan of the abdomen. CT scan of the abdomen with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region (a) and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (d). The 2 tumors could be seen in the same regions on CT scans performed 1 (b, e) and 2 years before (c, f). The tumors had gradually increased in size.
Mentions: A 68-year-old woman who had been receiving hemodialysis for chronic renal failure due to diabetic nephropathy was referred to our hospital for treatment of retroperitoneal tumors. The tumors were detected by one of the abdominal computed tomography (CT) scans that she had regularly undergone. She had been diagnosed with diabetes mellitus at the age of 46 years and had received hemodialysis 3 times a week since she was 59 years of age. She had no history of symptoms of von Recklinghausen disease. There was no family history of cancer. On physical examination at the time of consultation, her body temperature was 36.6°C, blood pressure was 164/80 mm Hg, and pulse rate was 67 beats/min and normal in rhythm. Her height was 160 cm and weight was 67 kg. Hematocrit was 29.7% and hemoglobin level was 9.8 g/dl. In renal function tests, blood urea nitrogen was 35.6 mg/dl and serum creatinine level was 7.16 mg/dl. Serum levels of sodium, potassium and chloride were 136, 6.0 and 101 mEq/l, respectively. Other results of complete blood count and liver function tests performed on admission were within normal ranges. Serum levels of adrenaline, noradrenaline, dopamine, cortisol and aldosterone were within normal ranges (24 pg/ml, 207 IU/l, 5 IU/l, 12.2 μg/dl and 94.1 pg/ml, respectively). Serum levels of carcinoembryonic antigen and carbohydrate antigen 19-9 were within normal ranges. An abdominal CT scan with administration of intravenous contrast material showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region (fig. 1a, d). The patient had been regularly examined by CT scan due to chronic renal failure. Retrospectively, the 2 tumors had never been pointed out by a physician but had existed in the same regions on a CT scan for 1 (fig. 1b, e) and 2 years (fig. 1c, f) before admission. The mean doubling times of the tumors in the left adrenal region and para-aortic region were 422 days and 270 days, respectively. The tumors had gradually increased in size on CT. Preoperative diagnosis was multiple pheochromocytomas or nonfunctioning adrenocortical carcinomas with lymph node metastasis, and she underwent an operation. On exploration of the intra-abdominal cavity, there were 2 tumors. One was in the para-aortic region and the other was in the left adrenal region. The tumor in the left adrenal region had compressed the left normal adrenal gland but was easily detached. Both tumors were completely excised and were diagnosed as schwannomas by microscopic examination of frozen sections.

Bottom Line: An abdominal computed tomography (CT) scan showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region.The tumors were completely resected.If the tumor increases in size, complete resection should be performed for pathological diagnosis.

View Article: PubMed Central - PubMed

Affiliation: Departments of Surgery and Hiroshima Prefectural Hospital, Hiroshima, Japan.

ABSTRACT
Schwannomas are benign tumors mostly arising from the head and neck. Retroperitoneal schwannomas are rare. Here we report the case of a 68-year-old woman with multiple retroperitoneal schwannomas. An abdominal computed tomography (CT) scan showed 1 non-enhancing mass with a low-density area, 4.6 cm in diameter, in the left adrenal region and another non-enhancing mass with a low-density area, 2.9 cm in diameter, in the para-aortic region. The patient had regularly undergone CT scans for malignant tumor screening in maintenance dialysis patients. Retrospectively, the 2 tumors had existed in the same regions in previous CT scans and had gradually increased in size. The tumors were completely resected. Pathological diagnosis of both tumors was schwannoma. When a CT scan shows a slowly growing retroperitoneal tumor with a low-density area, schwannoma should be considered. If the tumor increases in size, complete resection should be performed for pathological diagnosis.

No MeSH data available.


Related in: MedlinePlus