BÁO CÁO TRƯỜNG HỢP LÂM SÀNG: PHẪU THUẬT NỘI SOI Ổ BỤNG CẮT BƯỚU SCHWANNOMA SAU PHÚC MẠC TẠI BỆNH VIỆN ĐA KHOA KHU VỰC THỦ ĐỨC

Abstract

Introduction: Retroperitoneal schwannoma is a rare neurogenic tumor, accounting for less than 2% of all retroperitoneal tumors. Most schwannomas are benign; however, they are often diagnosed late because patients are asymptomatic or present with nonspecific symptoms. Definitive diagnosis is established by histopathological examination after surgical resection. Currently, complete surgical excision is the mainstay of treatment. The choice between open surgery and laparoscopic resection depends on tumor size, location, and the surgeon’s experience.

Methods: We report a case of retroperitoneal schwannoma that was successfully diagnosed and treated.

Case presentation: A 25-year-old female with no significant past medical history presented with dull left flank pain. Computed tomography revealed a left retroperitoneal mass measuring 100 × 50 × 40 mm with an attenuation of approximately 30 Hounsfield units. The patient underwent laparoscopic surgery using four trocars. During tumor dissection, a diaphragmatic tear occurred, exposing the left pleural cavity. A 16-Fr chest tube was inserted for pleural drainage. After complete tumor excision, air evacuation was performed and the diaphragm was repaired, followed by removal of the chest tube. The operative time was 155 minutes and estimated blood loss was 50 mL. The postoperative course was uneventful, and the patient was discharged on postoperative day 5. Histopathological examination confirmed a benign schwannoma.

Conclusion: Retroperitoneal schwannoma is a rare condition with nonspecific clinical presentation. Definitive diagnosis relies mainly on postoperative histopathology. Complete surgical resection remains the standard treatment. Laparoscopic surgery can be a safe and effective approach in selected cases, offering the benefits of minimally invasive surgery.