A Huge 5kg-Intra-Abdominal Ancient Schwannoma with A Recurrence-A Case Report

Introduction- This is a rare case of a recurrent huge intrabdominal Ancient Schwannoma, the size of which has not been reported before. This case report aims to enrich the literature on cases of undiagnosed abdominal masses. Clinical features-The patient complained of huge abdominal distension, weight loss, and breathlessness of 4 months duration. The important clinical findings were multiple cutaneous painless swellings, hyperpigmented patches on the trunk, and a mass occupying the whole of the abdomen. Management-A diagnosis of visceral manifestation of neurofibromatosis was made to rule out an intra-abdominal malignancy. Preoperative Abdominal Computed Tomography (CT) scan revealed a huge intrabdominal mass while a CT-guided biopsy showed a Benign Mesenchymal tumor. He had an exploratory laparotomy, and the mass was totally excised. The recovery was uneventful, and the outcome was excellent. Histopathology showed that the tumor was a Schwannoma with no malignancy. However, 5 months after, the swelling recurred and he was eventually lost to follow up. Conclusion- The rarity of Intra-abdominal Schwannomas and absent or non-specific signs and symptoms present the surgeon with a diagnostic dilemma. Preoperative Abdominopelvic CT scan, Ultrasound scan, and Magnetic Resonance Imaging are necessary imaging modalities. Complete excision at surgery reduces recurrence. Close follow-up is essential.