Surgical management of ancient retroperitoneal schwannoma.

Schwannomas are benign and rare entities of peripheral nerve sheath origin. The clinical presentation depends the size of tumor, and they may cause symptoms of abdominal pain, urinary difficulties, anemia, hematuria, and abdominal mass as a result of the pressure of the tumor to the adjacent structures. The diagnosis can only be established by immunohistochemical study. Complete surgical clearance remains the mainstay of treatment. We report the case of a 35-year-old female patient consulted for chronic abdominal pain. Abdominal ultrasound and abdomino-pelvic CT scan identified a well-delineated, heterogenous retroperitoneal mass developed in anteraortocaval region measuring 55 × 65 × 88 mm. The lesion seemed to repress the inferior vena cava, and enhanced with contrast administration. The histopathological panel confirmed the diagnosis of retroperitoneal schwannoma.

Intraductal papillary mucinous neoplasm of the pancreas presenting as a giant abdominal mass: A case report.

INTRODUCTION: Intraductal papillary mucinous neoplasms (IPMNs) constitute a group of rare conditions with a potential for malignant degeneration. The appearance of symptoms should suggest degeneration. This case demonstrates an unusual case of a patient presenting an intestinal type IPMN that was revealed by a large abdominal mass. CASE REPORT: 47-year-old woman with a history of hydatid cyst of the liver. The patient was admitted to our hospital for management of large abdominal mass measuring 185 × 128*190 mm. Intra-operative findings showed a voluminous tumor, of approximately 20 cm in all its dimensions, with double solido-cystic component at the expense of the neck and the body of the pancreas. The patient underwent splenopancreatectomy. The histopathological examination confirmed the presence of intestinal type of IPMN of pancreas. DISCUSSION: Acute pancreatitis is revealed in the majority of cases of IPMNs, related to duct obstruction by secreting mucus plug. IPMNs are rarely the cause of a large abdominal mass. They are cystic lesions of slow evolution, macroscopically visible and rarely macrocystic, unlike serous cystadenoma. The tumor size is a powerful indicator of the malignancy of IPMNs. The current definitive and ideal treatment for main duct and mixed type IMPNs is a surgical resection. CONCLUSION: IPMNs are a cystic lesion, rarely revealed by a large mass.