International journal of surgery case reports · 2025
Incidental giant renal schwannoma misdiagnosed as angiomyolipoma and low-grade spindle cell neoplasm: A case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Djafari Anahita Ansari, Samenezhad Sina, Seifipoor Mohammad, Rafighi Dorna
Аннотация
INTRODUCTION AND IMPORTANCE: Renal schwannomas are extremely rare benign tumors of the peripheral nerve sheath, accounting for less than 1 % of renal masses. Due to their nonspecific clinical and radiologic features, they are frequently misdiagnosed, posing a diagnostic challenge.
CASE PRESENTATION: We report a 63-year-old male with chronic right flank pain and a right staghorn calculus. During preoperative evaluation for percutaneous nephrolithotomy (PCNL), a large retroperitoneal mass adjacent to the left kidney was incidentally found. Initial core needle biopsy suggested angiomyolipoma, later revised to a low-grade spindle cell neoplasm. Complete surgical resection via retroperitoneal approach was performed. Histopathology confirmed a diagnosis of schwannoma with typical Antoni A and B areas.
CLINICAL DISCUSSION: Renal schwannomas can mimic various renal neoplasms radiologically and histologically. Core needle biopsy may be misleading in heterogeneous tumors like schwannomas. Complete excision followed by histopathologic evaluation remains essential for definitive diagnosis. A multidisciplinary approach is critical to avoid misdiagnosis and guide optimal management.
CONCLUSION: This case emphasizes the importance of considering schwannoma in the differential diagnosis of retroperitoneal masses. Surgical resection with thorough pathological analysis is key to accurate diagnosis and effective treatment.
CASE PRESENTATION: We report a 63-year-old male with chronic right flank pain and a right staghorn calculus. During preoperative evaluation for percutaneous nephrolithotomy (PCNL), a large retroperitoneal mass adjacent to the left kidney was incidentally found. Initial core needle biopsy suggested angiomyolipoma, later revised to a low-grade spindle cell neoplasm. Complete surgical resection via retroperitoneal approach was performed. Histopathology confirmed a diagnosis of schwannoma with typical Antoni A and B areas.
CLINICAL DISCUSSION: Renal schwannomas can mimic various renal neoplasms radiologically and histologically. Core needle biopsy may be misleading in heterogeneous tumors like schwannomas. Complete excision followed by histopathologic evaluation remains essential for definitive diagnosis. A multidisciplinary approach is critical to avoid misdiagnosis and guide optimal management.
CONCLUSION: This case emphasizes the importance of considering schwannoma in the differential diagnosis of retroperitoneal masses. Surgical resection with thorough pathological analysis is key to accurate diagnosis and effective treatment.