Laparoscopic hand-assisted resection of a rare intra-adrenal schwannoma

Schwannomas are well-differentiated mesenchymal tumors of the of Schwann cells that are usually benign. A lack of specific radiographic characteristics makes definitive preoperative diagnosis difficult. Therefore, despite the benign nature of these tumors, the gold-standard for symptomatic tumors is surgical resection. Here, we report the surgical management of a 37-year-old male whose pre-surgical evaluation identified a tumor in the right retroperitoneal space between the right adrenal gland and intraperitoneal porta hepatis. As a result of both the preliminary pathologic diagnosis and the close proximity of the tumor to the porta hepatis, laparoscopic hand-assisted surgical resection of the retroperitoneal tumor was performed. Postoperative pathologic diagnosis demonstrated a benign intra-adrenal schwannoma. This case highlights the importance of a broad differential diagnosis for any large retroperitoneal tumor and the requirement for post-operative pathologic diagnosis to characterize the definitive tumor location and malignant potential of the tumor.