PDF(Pubmed)
Abstract：
BACKGROUND Neurilemmomas are rare tumors derived from the Schwann cells that comprise the peripheral nerve sheaths. They have a slow growth and rarely display malignancy. Early diagnosis is rare, and the treatment consists by surgical resection. Although robotic-assisted surgery is commonly used for treating retroperitoneal diseases, there are few reports of resection of retroperitoneal and pelvic schwannoma through robotic-assisted surgery. In the present study, we reported a case of complete excision of a benign retroperitoneal schwannoma of the obturator nerve by robotic-assisted surgery. CASE REPORT A 51-year-old woman was referred by her gynecologist for left pelvic discomfort of a 3-month duration. The physical examination was normal, but a computerized tomography scan of the abdomen and pelvis showed an expansive pelvic lesion in the topography of the left iliac vessels, a hypodense contrast enhancement measuring 4.6×3.4 cm. Magnetic resonance imaging showed an extraperitoneal lesion located medially and inferiorly to the left external iliac vessels, with a size of 4.9×3.7 cm, and of probable neural etiology. Surgical resection of the tumor was recommended because of the diagnostic hypothesis of obturator nerve schwannoma. CONCLUSIONS This case showed that retroperitoneal neurilemmomas are difficult to diagnose owing to a lack of specific symptoms, and the best treatment is complete tumor resection. The use of robotic techniques gives greater dexterity to the surgeon, since it provides high-definition 3-dimensional vision, which can make the removal of retroperitoneal tumors susceptible to minimally invasive resection in a safe and effective way.
摘要：
背景技术神经鞘瘤是源自包含外周神经鞘的施万细胞的罕见肿瘤。它们生长缓慢，很少表现出恶性肿瘤。早期诊断很少见，治疗包括手术切除。尽管机器人辅助手术通常用于治疗腹膜后疾病，通过机器人辅助手术切除腹膜后和盆腔神经鞘瘤的报道很少。在本研究中,我们报告了一例通过机器人辅助手术完全切除闭孔神经的良性腹膜后神经鞘瘤的病例。病例报告一名51岁女性因左侧骨盆不适3个月而被其妇科医生转诊。体检正常,但是腹部和骨盆的计算机断层扫描扫描显示左髂血管的地形上有一个扩张性骨盆病变，测量4.6×3.4厘米的低密度对比增强。磁共振成像显示位于左髂外血管内侧和下方的腹膜外病变，尺寸为4.9×3.7厘米，和可能的神经病因。由于闭孔神经神经鞘瘤的诊断假设，建议手术切除肿瘤。结论该病例显示腹膜后神经鞘瘤由于缺乏特定症状而难以诊断。最好的治疗方法是完全切除肿瘤。机器人技术的使用为外科医生提供了更大的灵活性，因为它提供了高清三维视觉，这可以使腹膜后肿瘤的切除易于以安全有效的方式进行微创切除。
