A Case of Laparoscopically Resected Primary Mesenteric Schwannoma

Abstract

A 54-year-old woman underwent computed tomography (CT) during an emergency outpatient visit for right ureteral calculus, which showed an intrapelvic mass. On contrast-enhanced CT, an enhanced, well-demarcated mass measuring 45 mm and exhibiting calcification was observed on the dorsal side of the right intrapelvic area. The differential diagnosis initially included right ovarian tumor, but since there was no communication with the right ovarian vein, whereas communication with the superior mesenteric artery and vein was present, it was considered to be derived from the mesentery of the small intestine, and the decision was made to resect it, with a differential diagnosis of leiomyoma and gastrointestinal stromal tumor. The primary tumor was located in the mesentery of the small intestine, and since the marginal arteries could not be preserved, laparoscopic partial small bowel resection was conducted. The histopathological diagnosis was schwannoma. The patient's postoperative course was uneventful, and at 1 year 7 months after surgery, there was no recurrence. No cases of lymph node metastasis of schwannoma have been reported, and, in principle, the tumor is removed together with its capsule. Concomitant bowel resection is required if malignancy is suspected or the location of the tumor demands it. Since some cases of malignancy have been reported, care must be taken not to damage the capsule during removal. Primary mesenteric schwannoma is an extremely rare condition, and laparoscopic resection of a case is reported.