Recurrent Malignant Peripheral Nerve Sheath Tumor encasing the uretera case report

Abstract

54 yr male known case of retroperitoneal
tumor, underwent enbloc excision of tumor
(size20x15 cm) with Left partial
nephrectomy on 18-2-2011. Biopsy reported
as malignant peripheral
nervesheath tumor (Gr.1), with negative
margins. Now admitted with CO (Lt)
Lower abdominal pain since 1month
without urinary symptoms. Examination
findings were unremarkable. On investigation-
RFT-normal, USG - showed well
defined hypoechoic mass lesion
5.5x4.5cm (Lt) iliac fossa, CECTABDrevealed
7.5x7.8x5.5cm well enhancing
(Lt) retroperitoneal tumor with
encasement of (Lt) mid ureterinfiltration
of left psoas muscle. Laparotomy revealed
12x8 cm mass posterior to sigmoid
mesocolon,adherent to iliac vessels,
encasing mid ureter (Lt), Enbloc excision
of tumor along with involved ureter
(10cm) was done and resultant ureteric
loss was managed by ureteroneocystostomy
with long boariflap with 5Fr
DJ stenting. Post.op period
uneventful.This case is presented because
of its rarepresentation. Despite partial
nephrectomy having been done and long
segment ureteric loss, thekidney was still
salvaged using long Boari flap.