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Kamiya A, Yamagata Y, Yoshida H, Ishizu K, Wada T, Hayashi T, Otsuki S, Yoshikawa T, Katai H. Laparoscopic resection of a primary diaphragmatic schwannoma: a case report and literature review. BMC Surg 2020; 20:289. [PMID: 33213428 PMCID: PMC7678197 DOI: 10.1186/s12893-020-00963-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/12/2020] [Indexed: 11/25/2022] Open
Abstract
Background Schwannomas are nerve sheath tumors that commonly originate from the stomach and small intestine. A primary schwannoma of the diaphragm is rare and does not show any symptoms until it grows to a certain size. Hence, it is extremely rare that it was found at a size that allowed resection under videoscopic surgery. Case presentation A 77-year-old woman was referred to our department for surgical treatment of a tumor located near the gastric fornix. She underwent a routine esophagogastroduodenoscopy 2 years and 7 months prior to the referral. It was suspected that she had a submucosal tumor measuring 10 mm, located in the fornix, and was then referred to her previous physician. During her follow-up, endoscopic ultrasonography (EUS) revealed that the cystic structure had continued to grow toward the gastric wall, and she was then referred to the endoscopy division of our hospital. She continued to be followed-up, and it was noted that the tumor was gradually increasing in size. Therefore, she requested surgical resection, and was finally referred to our division. Since the tumor was rather small, we planned a laparoscopic surgery. An initial examination during the operation revealed that the tumor was located on the left diaphragm. Since the tumor was relatively small and visibility was good, we decided to continue with the laparoscopic surgery. Partial diaphragmectomy with complete inclusion of the tumor was performed, and the defect of the diaphragm was directly closed by a running suture. Pathological examination revealed a benign schwannoma that had originated from the diaphragm. To support our findings, we also reviewed the scientific literature on diaphragmatic schwannoma cases reported up to April 2020. Conclusions In this extremely rare case, we successfully resected the diaphragmatic schwannoma using laparoscopic surgery.
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Affiliation(s)
- Ayako Kamiya
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Yukinori Yamagata
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - Hiroshi Yoshida
- Division of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Kenichi Ishizu
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takeyuki Wada
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Tsutomu Hayashi
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Sho Otsuki
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Takaki Yoshikawa
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Hitoshi Katai
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
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Shabana W, Raslan W, Hassan S, Al-Tartir T. Schwannoma masquerading as adrenocortical tumor: A case report and review of literature. Urol Case Rep 2019; 26:100926. [PMID: 31297325 PMCID: PMC6597528 DOI: 10.1016/j.eucr.2019.100926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 05/28/2019] [Indexed: 11/25/2022] Open
Abstract
Schwannomas arises from retroperitoneal space are rare tumors. Adrenal Schwannomas are often misdiagnosed due to deficient of distinctive radiological findings. We report a case of adrenal schwannoma presented with vague abdominal pain. Initially, the patient was diagnosed as adrenocortical tumor that was treated with robotic adrenalectomy. Histopathological and immuno-histochemical examination revealed schwannoma. We will report the case and review the literature regarding this rare tumor.
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Affiliation(s)
- Waleed Shabana
- Johns Hopkins Aramco Healthcare-Urology Department, Saudi Arabia.,Faculty of Medicine-Zagazig University-urology Department, Egypt
| | - Wasim Raslan
- Johns Hopkins Aramco Healthcare-Urology Department, Saudi Arabia
| | - Said Hassan
- Johns Hopkins Aramco Healthcare-Urology Department, Saudi Arabia
| | - Tareq Al-Tartir
- Johns Hopkins Aramco Healthcare-Urology Department, Saudi Arabia
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Abraham E, Schwartz G. Primary schwannoma of the diaphragm. Proc (Bayl Univ Med Cent) 2019; 32:266-267. [PMID: 31191150 DOI: 10.1080/08998280.2018.1553498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 11/20/2018] [Accepted: 11/26/2018] [Indexed: 01/30/2023] Open
Abstract
Primary schwannoma of the diaphragm is exceedingly rare. We report a case identified on surveillance imaging for a previous lung cancer that was diagnosed via thoracoscopic resection.
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Affiliation(s)
| | - Gary Schwartz
- Department of Thoracic Surgery and Lung Transplantation, Baylor University Medical CenterDallasTexas
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Bhattar R, Tomar V, Dhakad DS, Agarwal N. Benign diaphragmatic neurilemmoma mimicking a left adrenal cyst. Turk J Urol 2017; 44:87-90. [PMID: 29484235 DOI: 10.5152/tud.2017.26780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2016] [Accepted: 12/05/2016] [Indexed: 11/22/2022]
Abstract
Neurilemmomas are benign, slow growing, encapsulated nerve sheath tumor. These tumors arise from the schwann cells of neural crest. Neurilemmomas can manifest in various form according to site, extent and severity of involvement of organ. Diaphragmatic neurilemmomas are very unusual and even difficult to diagnose on preoperative imaging. We will report a case of 39 year old male, who presented with complaints of occasional left flank pain for one year and subsequently investigated, which showed left adrenal cyst with haemorrhagic fluid content. On the contrary, when surgical exploration of the lesion was done, it showed a cyst within the diaphragm, completely separated from left kidney and left adrenal with haemorrhagic content in situ. Histopathological examination of the lesion showed it to be a benign neurilemmoma with cystic degeneration. Post opearatively patient did well. We believe that this is the first case report, which is addressing such kind of initial manifestation of diaphragmatic neurilemmomas.
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Affiliation(s)
- Rohit Bhattar
- Department of Urology, Sawai Man Singh Medical College, Jaipur, Rajasthan
| | - Vinay Tomar
- Department of Urology, Sawai Man Singh Medical College, Jaipur, Rajasthan
| | | | - Neeraj Agarwal
- Department of Urology, Sawai Man Singh Medical College, Jaipur, Rajasthan
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Hobbs DJ, McLellan J, Schlatter MG. Schwannoma of the diaphragm--a pediatric case report and review of the literature. J Pediatr Surg 2012; 47:e5-7. [PMID: 22498413 DOI: 10.1016/j.jpedsurg.2011.11.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Revised: 11/04/2011] [Accepted: 11/23/2011] [Indexed: 10/28/2022]
Abstract
Diaphragmatic tumors are uncommon and difficult to diagnose in the pediatric population. Schwannoma is a benign, slow-growing peripheral nerve sheath tumor that is most commonly associated with the extremities in childhood. We herein report a schwannoma of the diaphragm in a pediatric patient and review the pediatric literature.
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Affiliation(s)
- David J Hobbs
- Pediatric Surgery, Helen DeVos Children's Hospital and Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA.
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Abstract
Primary tumors of the diaphragm are rare. The most common benign cystic lesions of the diaphragm are bronchogenic or mesothelial cysts, while the most common benign solid lesion is a lipoma. Benign tumors of the diaphragm are resected if they are symptomatic or if there is a doubt about the diagnosis. The most common primary malignant lesion is rhabdomyosarcoma. Malignant tumors are treated based on histology and often with chemotherapy and/or radiation along with surgical resection if feasible. Endometriosis, a benign process that metastasizes to the diaphragm, is typically treated medically; surgical ablation or resection is considered only after failed conservative treatment. Surgical resection of metastatic malignant tumors, such as ovarian cancer and thymoma, as well as malignancies affecting the diaphragm by direct extension, such as mesothelioma, lung, and esophageal cancer, may provide some survival advantage.
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Affiliation(s)
- Min Peter Kim
- Division of Thoracic and Cardiovascular Surgery, MD Anderson Cancer Center, The University of Texas, 1515 Holcombe Boulevard, Unit 445, Houston, TX 77030-4009, USA
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