Perineal schwannoma (case report and review)
https://doi.org/10.33878/2073-7556-2024-23-4-114-123
Abstract
Schwannoma (also known as neurilemmoma) is a type of benign tumor that originates from the myelin sheath around of peripheral nerves. It is composed of schwann cells, which are specialized cells that help to insulate nerve fibers. Schwannomas are relatively rare, accounting for only 5% of all benign tumors in the perineal region. They are usually asymptomatic and are only detected when they come into contact with other organs or structures, causing symptoms such as compression. Preoperative diagnosis of schwannoma is challenging, as it is often difficult to distinguish it from other types of tumors in the same area. The final diagnosis can only be confirmed by intraoperative histology.
The method of choice for benign neurilemmomas is complete removal, as they continue growth after resection. Removing part of the tumor may be an option in cases where removing the neoplasm en bloc could damage adjacent structures, such as anal sphincter, levators, rectum, vagina and urethra.
Clinical case: twenty-five years old female, had complaints of a tumor in the left buttock area and discomfort in a sitting position for 3 years. Pelvic MRI with intravenous contrast revealed a tumor 6.0 × 5.1 × 9.0 cm in the left ischial region. Surgical removal of the tumor was performed.
About the Authors
A. S. Bragina
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Anastasia S. Bragina
Salyama Adilya st., 2, Moscow, 123423
I. S. Anosov
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Ivan S. Anosov
Salyama Adilya st., 2, Moscow, 123423
R. Yu. Khryukin
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Roman Yu. Khryukin
Salyama Adilya st., 2, Moscow, 123423
O. A. Maynovskaya
Ryzhikh National Medical Research Center of Coloproctology
Russian Federation
Russian Federation
Olga A. Maynovskaya
Salyama Adilya st., 2, Moscow, 123423
References
1. Verocay J. Zurkenntnis der neurofibrome. Beitr Pathol Anat All g Pathol. 1910;48:1–69.
2. Masson AP. Experimental and spontaneous schwannomas (peripheral gliomas): Part I. Am J Pathol. 1932;8:367–370.
3. Stout AP. The peripheral manifestations of the specific nerve sheath tumor (neurilemmoma). Am J Cancer. 1935;24:51–55.
4. Panwar P, Kumar S, Singh S, et al. Giant abdominoperineal malignant schwannoma: an unusual presentation and surgical challenge. Case Rep Urol. 2015;2015:728062. doi: 10.1155/2015/728062
5. Hughes MJ, Thomas JM, Fisher C, et al. Imaging features of retroperitoneal and pelvic schwannomas. Clin Radiol. 2005;60:886–893.
6. Cecconi F, Maiolino G, Lanzi F, et al. Perineal schwannoma: an unusual tumor and clinical presentation — first case with erectile dysfunction associated with this neoplasm. Urologia. 2018 May;85(2):83–86. doi: 10.5301/uj.5000247
7. Chaturvedi C, Chaturvedi HT, Damor PK, et al. Perianal schwannoma: An unusual location. Indian J Pathol Microbiol. 2024 Apr 1;67(2):474–476. doi: 10.4103/ijpm.ijpm_596_22
8. Majbar A, Hrora A, Jahid A, et al. Perineal schwannoma. BMC Res Notes. 2016 Jun 13;9:304. doi: 10.1186/s13104-016-2108-1
9. Baird B, Gibbs EM, Rademaker NJ, et al. Perineal schwannoma: A case report with novel genitourinary association and histopathology. Urol Case Rep. 2019 Sep 17;28:101021. doi: 10.1016/j.eucr.2019.101021
10. Kim YK, Ahn SK, Lee SH. A case of perineal schwannoma resembling a skin tag. J Dermatol. 1999 Oct;26(10):687–690. doi: 10.1111/j.1346-8138.1999.tb02073.x
11. Pantè S, Terranova ML, Leonello G, et al. Perineal schwannoma. Can J Surg. 2009 Feb;52(1):8–9.
12. González Plo D, GarcíaPavía A, León Gámez CL, et al. Perianal tumour simulating an abscess. Gastroenterol Hepatol. 2017 JunJul;40(6):398–399. English, Spanish. doi: 10.1016/j.gastrohep.2016.05.001
13. Ravier E, Lopez JG, Augros M, et al. Casclinique et revue de la littérature: un schwannome périnéal [Case report and review of the literature: a perineal schwannoma]. Prog Urol. 2011 May;21(5):360– 363. French. doi: 10.1016/j.purol.2010.07.002
14. Sun XL, Wen K, Xu ZZ, et al. Magnetic resonance imaging findings for differential diagnosis of perianal plexiform schwannoma: Case report and review of the literature. World J Clin Cases. 2018 May 16;6(5):88–93. doi: 10.12998/wjcc.v6.i5.88
15. Pan J, Jing H, Tian X, et al. Schwannoma with an uncommon anal location. Oncol Lett. 2014 Nov;8(5):1945–1946. doi: 10.3892/ol.2014.2459
16. Verma AK, Pandey A, Gupta A, et al. Perineal Schwannoma in a Child-an Uncommon Presentation. Indian J Surg Oncol. 2017 Sep;8(3):414–416. doi: 10.1007/s13193-017-0638-1
17. Kornev A.I., Boriskin A.A., Kozhukhov D.A., et al. Benign retroperitoneal schwannoma. Treatment and prevention. 2019;9(2);69-72. (in Russ.).
18. Mosin I.V., Tikhonenko O.V., Nuraliev S.M., et al. Schwannoma of the posterior mediastinum (literature review and rare clinical case). Practicaloncology. 2019;20(1);80-84. doi: 10.31917/2001080 (in Russ.).
19. Gorgan M, Sandu AM, Bucur N, et al. Sciatic nerve schwannoma — case report. Romanian Neurosurgery. 2009;15:27–31.
20. Kransdorf MJ. Benign soft tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. Am J Roentgenol. 1995;164:395–402.
21. Abel ME, Nehme Kingsley AE, Abcarian H, et al. Anorectal neurilemomas. Dis Colon Rectum.1985;28:960–961.
22. Carlson HE. Neurilemmoma of the perineum. J urol. 1965 aug;94:158–159. doi: 10.1016/s0022-5347(17)63591-2
23. Chiabai O, Marbaix E, Dragean C. Schwannoma: A Rare Cause of Perineal Pain. J Belg Soc Radiol. 2022 Feb 18;106(1):8. doi: 10.5334/jbsr.2738
24. Kim D, George E, Nalla M, et al. A rare case of a solitary perianal neurofibroma. Int Surg J. 2018;5:2633–5.
25. Mohr S, Peterson NE. Perineal neoplasms. J Urol. 1975 Nov;114(5):752–7. doi: 10.1016/s0022-5347(17)67134-9
26. Auelova A.B. Musabekova S.A. Schwannoma of the bartholin gland — a clinical case. The scientific aspect. 2019;8(1):931–935. (in Russ.).
27. Zingerenko M.B., Rotin D.L., Lakhno D.A. Extratesticular scrotal schwannoma. Clinical case and literature review. Oncourology. 2016;12(1):97–101. (in Russ.). doi: 10.17650/1726-9776-2016-12-1-97-101
28. Park MJ, Seong GH, Park M, et al. Giant Plexiform Neurofibroma of the Perineum and Pelvic Cavity Manifesting as Segmental Neurofibromatosis. Ann Dermatol. 2019 Jun;31(3):331–334. doi: 10.5021/ad.2019.31.3.331
29. Weston SD, Marten M, Cohan MH, et al. Neurofibroma of the rectum and colon. J Internat Coll Surg. 1963;40:285–293.
30. Baranova I.B., Slavnova E.N., Petrov A.N. Cytological diagnosis of schwannoma: 3 clinical observations. News of clinical cytology in Russia. 2023;27(2):25–29. (in Russ.). doi: 10.24412/1562-4943-2023-2-0004
Review
For citations:
Bragina A.S., Anosov I.S., Khryukin R.Yu., Maynovskaya O.A. Perineal schwannoma (case report and review). Koloproktologia. 2024;23(4):114-123. https://doi.org/10.33878/2073-7556-2024-23-4-114-123
Views:
504
Email this article 
