Giant retroperitoneal lumbar Schwannoma: a case report and review of literature

Schwannomas are benign peripheral nerve sheath tumors arising from Schwann cells. Retroperitoneal localization for schwannomas is extremely rare [%3]. The primary surgical approach for such tumors is total resection. This study aimed to report the case of a schwannoma with giant, retroperitoneal extension originating from the L3 nerve root. A 43-year-old female patient was admitted to the department with a cellulosic schwannoma pathology after excisional biopsy at another center. The patient's neurological examination was normal. The lumbar-abdominal contrast-enhanced magnetic resonance imaging [MRI] of the patient revealed a mass lesion in the vertebral compartment 2 × 3 × 3 cm3 and psoas component 8 × 4 × 3 cm3 in size, extending from the right L3 nerve root into the right psoas muscle. The patient was operated postoperatively in the first stage and then using the anterior approach with intraoperative neuromonitoring. Postoperative contrast-enhanced MRI showed no enhancing tumoral lesions. The pathology result was compatible with schwannoma World Health Organization Grade 1. Two-stage surgical procedure in such cases should be preferred to prove the adequacy of the surgical field and avoid the complications that may occur in neighboring anatomical structures during resection of circumferentially circumscribed tumors. Urgent surgical intervention is needed for retroperitoneal lumbar schwannomas. Moreover, elective surgery planning is necessary, and preoperative evaluations should be performed

Comparison of changes in body image of patients with renal calculi treated by pyelolithotomy or percutaneous nephrolithotomy

To compare changes in body image of patients who had pyelolithotomy [PYL] or percutaneous nephrolithotomy [PNL] for kidney stones Prospective, descriptive study Elazig Education and Research Hospital, Turkey A total of 69 patients, who had PNL or PYL done for renal stones, were evaluated, prospectively. Patients were divided into two groups: PNL [39 patients] and PYL [30 patients]. Body dismorphic disorder scale [BDDS] was used to measure body image changes of these patients before, one and six months after the operation. The patients were questioned and their answers were noted. BDDS score was calculated according to the answers. Mean BDDS scores between the two groups were statistically compared by t-test method The difference of mean BDDS scores between two groups before the operation, and six months after the operation was not statistically significant[p>0.4andp>0.4respectively]. However, mean BDDS scores one month after the operation were significantly higher in PYL group and perception of body image was worse [p = 0.01]. In early postoperative period, perception of change in body image was significantly worse in the PYL group. However, in late postoperative period, there were no significant differences between the two groups of patients. For these reasons, we consider that the changes in body image should not be a determining factor for selecting the surgical approach