Robotic‐assisted surgical removal of pelvic schwannoma: a novel approach to a rare variant

Abstract

BACKGROUND: Robotic-assisted excision of a pelvic schwannoma is presented. METHODS: A 27 year-old female presented with occasional numbness of the right thigh. Imaging studies revealed a large mass adjacent to the right ovary. Robotic surgery with adjunctive electrophysiological monitoring was performed. The mass was adhered to the L4, L5 roots and was displacing the iliac vessels and the ureter. The tumour bulk was decompressed and total excision was facilitated. RESULTS: Pathology revealed a neoplasm consisting of spindle cells. Immunochemistry revealed S-100(+) and a growth index Ki-67 < 1%. These findings were consistent with the diagnosis of ancient schwannoma. The intraoperative time was comparable to laparoscopy and the patient had an uneventful recovery. CONCLUSION: Ancient schwannoma is often diagnosed only when it is large enough to produce symptoms. Robotic surgery with adjunctive electrophysiological monitoring is a safe technique for the removal of large pelvic neurinomas.