Rare case of Retrorectal Schwannoma-study of a diagnostic and therapeutic challenge

Primary sacral and presacral lesions are considered very uncommon with an estimated incidence of benign lesions of 0.01 cases per 100,000 general population and are common in the older age group, often more than 70 years of age. Retrorectal schwannoma is a benign primary presacral lesion that is extremely rare and often misdiagnosed before the pathological diagnosis is made. Only about 0.5–5% of all schwannomas occur in the retrorectal space and represent 1 in 250 of all retrorectal tumours

A 42-years-old, female patient was admitted for lower-back pain for seven days. The retrorectal mass was detected on imaging, and she underwent laparoscopic excision. Pathological examination revealed a rare retrorectal schwannoma.

Retrorectal location of schwannomas is rare and the preoperative diagnosis is very difficult as the clinical features and the radiological features are non-specific. In addition, these tumours can be found incidentally on routine rectal or pelvic examinations. As these tumours are benign, encapsulated, and non-invasive, this entity has an excellent prognosis. Despite the tumours' rarity and variety, we concur with the literature that surgical management is required to obtain a clear diagnosis and avoid consequences such as malignant transformation.

Thus, Diptee Poudel et al. concluded that retrorectal Schwannoma presents a diagnostic and therapeutic challenge. Identification is important because surgical excision, either open or laparoscopic, is curative.

Reference:

Diptee Poudel, Suraj Shrestha, Elisha Poddar, Prarthana Pacchai, Bishnu Prasad Kandel, Paleswan Joshi Lakhey. Retrorectal schwannoma in a middle-aged female: A case report. International Journal of Surgery Case Reports. Volume 96, 2022, 107270, ISSN 2210-2612. https://doi.org/10.1016/j.ijscr.2022.107270.