The occurrence of neuroma in the pelvicarea in women – a review of the literature and case report
Journal Title: Ginekologia i Położnictwo medical project - Year 2015, Vol 3, Issue 37
Abstract
Introduction. Neuroma (neurilemmoma, schwannoma) is derived from neurolemmocytes of peripheral nerves, usually sensory but also motor. Histologically, therearetwotypes of neuroma: Antoni A, with a solid structure and the presence of nuclearpalisades (Verocaybodies), and Antoni B, with loosecellularsystems and the presence of pseudocysticchanges with myxoidelements. It isbenign and extremelyrarelyundergoesmalignanttransformation. Degeneratedneurilemmoma (ancientschwannoma) is a rarevariant of neuroma, characterized by a reduction in cellnumber, degenerativechanges (cysts, calcification), bleeding and hyalinization. Thesechangesareattributed to “aging” as a result of tumor growth, leading to vascularinsufficiency. Histologically, ancientschwannomaischaracterized by a significantdecrease in the size of AntoniAarea (rich in cells) and expansion of Antoni B type. Purpose. A review ofliteratureconcerningthe occurrence of neuroma in the retroperitoneal space of the pelvis minor and in the female internal genital organs, including the period of pregnancy. Materials and methods. A review of therelevantliterature. It includedacase of neuroma treatedsurgically in the Department-a variant of ancientschwannoma. Results.Onlyfewreports on the occurrence of neuroma in the pelvis minor werefound. The treatment of choicein the case of neuroma, includingancientschwannoma, is a completesurgicalexcision, whichisoftenassociated with numerous intra- and postoperativecomplications. In the presentedcase, ancientschwannomalocated in the retroperitonealspace of the pelvis minor (perianal-presacral) was anobstacle for parturition. After performinganelectivecaesareansection (cc), the tumor was removed and peripartumhysterectomy was performed. In the literature,therewere no publicationsconcerning neuroma in thislocation, treatedsurgicallyduring cc in combination with peripartumhysterectomy. Conclusions. Neuromaslocated in thepelvisminoraredifficulttodiagnose; prior to surgery,theyareusuallydiagnosedincidentallyorwhentheirsizecauses the “mass effect”. Surgicalprocedures, due to theircomplexity, oftenrequire the involvement of multidisciplinaryteams of doctors and securinglargeamounts of blood and blood products.
Authors and Affiliations
Dobrosława L. Sikora-Szczęśniak, Wacław Sikora, Grzegorz Szcześniak
Keywords
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