Introduction:

Retroperitoneal tumors are rare; they account for 0.3-0.8% of neoplasms in general. Even with the medical-technological advances, they symbolize a diagnostic problem and, moreover, a great therapeutic challenge, since they put the patients at high risk, not only for the histological aggressiveness of most subtypes, but also for their proximity to neurovascular structures.

Case Report:

A 57-year-old female, with diagnosis of dyslipidemia and medical history of posterior deep vein thrombosis, after resection of extravascular leiomyoma in the right atrium, and partial section of the inferior vena cava. She went to the clinic for evaluation due a possible uterine-dependent pelvic tumor, classified as probable uterine myomatosis. Transvaginal ultrasound was performed, and revealed intramural myomatosis with calcium degeneration and solid retroperitoneal mass of pyriform shape with dimensions of 95 mm × 37 mm. A supra and infraumbilical medial approach was performed, where right lateral retroperitoneal tumor was identified by Cattel Braasch maneuver. In addition, the deep iliac vein was identified, which presented a 9 cm × 5 cm tumor, with stenosis at 2 cm from the bifurcation of the inferior vena cava, and proximal dilatation. The patient evolved appropriately, being discharged at 48 h.

Discussion:

Neurilemoma or schwannoma is a tumor arised from the peripheral nerve sheath that originates from the Schwann cells; they are a subclass of soft tissue tumors including: the neurofibroma, the solitary circumscribed neuroma, and the perineurioma. The exact etiology and pathogenesis of schwannomas remain unclear. Schwannomas are usually solitary, slow-growing and painless, predominating in women between the second and fifth decade of life. For this reason, they are usually identified incidentally during routine physical examinations or imaging studies as happened in our case.

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