Author(s): DOBROS?AWA L. SIKORA-SZCZ??NIAK1, GRZEGORZ SZCZ??NIAK2, WAC?AW SIKORA1
Introduction. Neuroma (neurilemmoma, schwannoma) is derived from neurolemmocytes ofperipheral nerves, usually sensory but also motor. Histologically, therearetwotypes of neuro-ma: Antoni A, with a solid structure and the presence of nuclearpalisades (Verocaybodies), andAntoni B, with loosecellularsystems and the presence of pseudocysticchanges with myxoide-lements. It isbenign and extremelyrarelyundergoesmalignanttransformation. Degeneratedneu-rilemmoma (ancientschwannoma) is a rarevariant of neuroma, characterized by a reduction incellnumber, degenerativechanges (cysts, calcification), bleeding and hyalinization. Thesechan-gesareattributed to “aging” as a result of tumor growth, leading to vascularinsufficiency.Histologically, ancientschwannomaischaracterized by a significantdecrease in the size ofAntoniAarea (rich in cells) and expansion of Antoni B type.Purpose. A review ofliteratureconcerningthe occurrence of neuroma in the retroperitonealspace of the pelvis minor and in the female internal genital organs, including the period ofpregnancy.Materials and methods. A review of therelevantliterature. It includedacase of neuroma treated-surgically in the Department-a variant of ancientschwannoma.Results.Onlyfewreports on the occurrence of neuroma in the pelvis minor werefound. Thetreatment of choicein the case of neuroma, includingancientschwannoma, is a completesur-gicalexcision, whichisoftenassociated with numerous intra- and postoperativecomplications. Inthe 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,the-rewere no publicationsconcerning neuroma in thislocation, treatedsurgicallyduring cc in com-bination with peripartumhysterectomy.Conclusions. Neuromaslocated in thepelvisminoraredifficulttodiagnose; prior to surgery,they-areusuallydiagnosedincidentallyorwhentheirsizecauses the “mass effect”. Surgicalprocedures,due to theircomplexity, oftenrequire the involvement of multidisciplinaryteams of doctors andsecuringlargeamounts of blood and blood products.