Myxoid Degenerated Giant Rectal Schwannoma Masquerading as Tailgut Cyst: A Rare Case Report
Published: 2022-07-19
Page: 238-243
Issue: 2022 - Volume 5 [Issue 1]
S. L. Harilal
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Kalayarasan Raja *
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
B. H. Srinivas
Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Biju Pottakkat
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Senthil Gnanasekaran
Department of Surgical Gastroenterology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
*Author to whom correspondence should be addressed.
Abstract
Background: Colorectal schwannomas are rare tumors often detected incidentally and frequently misdiagnosed on preoperative evaluation. They can grow to a large size and create a significant mass effect. A rare case of large rectal Schwannomas mimicking tailgut cyst and managed by a laparoscopic approach is described in the present report.
Case Presentation: A 48- year-old gentleman presented with urinary retention and constipation. Examination revealed an ill-defined hard mass in the left iliac fossa extending to the pelvis. Imaging revealed a 18x12x 9 cm cystic lesion suggestive of a tailgut cyst. The patient underwent Hand-assisted laparoscopic excision of the lesion. The tumor showed spindle cells with myxoid degeneration on microscopic examination and S-100 positivity in immunohistochemistry suggestive of Schwannoma. His postoperative course was uneventful, and there is no evidence of tumor recurrence at eight months of follow-up.
Conclusion: Rectal Schwannoma with myxoid degeneration can mimic tailgut cyst and pose a diagnostic challenge. The hand-assisted laparoscopic approach is feasible for excision of large rectal schwannomas.
Keywords: Giant rectal schwannoma, myxoid degeneration, tailgut cyst, Hand-assisted laparoscopic excision