妊娠中の付属器腫瘤を模倣した後腹膜神経鞘腫

Retroperitoneal schwannoma mimicking an adnexal mass in pregnancy.

• Rebecca Allen
• Lorin Lakasing

抄録

36歳の妊婦が第1期の検査を受けたところ、右側の複雑な嚢胞性腺腫瘤が偶発的に認められた。複雑な性質のため、骨盤超音波検査とMRIの繰り返しを含む更なる検査が行われたが、結論は得られなかった。集学的チームによる画像のレビューでは、腫瘤は後行性で、神経原性の起源であり、L5椎体が関与していることが判明した。妊娠は順調に進んだが、腫瘤が陣痛の進行を妨げる可能性があるため、妊娠39週に選択帝王切開で分娩された。産後の生検で神経鞘腫が確認された。切除が計画されていたが、女性は無症状であったため、家族のために手術を辞退した。2年後に再び妊娠し、2人目の妊娠も同様の方法で管理された。この間、神経鞘腫の大きさは安定していた。

A 36-year-old pregnant woman attended her first trimester scan and there was an incidental finding of a right-sided complex cystic adenexal mass. Further investigations including repeat pelvic ultrasound scans and MRI were performed due to its complex nature but were inconclusive. Multidisciplinary team review of images found the mass to be retroperitioneal, neurogenic in origin and involving the L5 vertebrae. The pregnancy continued to term and the baby was delivered at 39 weeks gestation by elective caesarean section due to the mass being likely to obstruct progress in labour. Postnatal biopsy confirmed a schwannoma. Plans were made for resection however as the woman was asymptomatic she declined surgery in favour of completing her family. She conceived again 2 years later and a second pregnancy was managed in the same way. The size of the schwannoma remained stable throughout this period.

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