The management of retroperitoneal giant schwannomas in AIDS patients: A case report

Retroperitoneal schwannomas are a rare disease. During the potent antiretroviral therapy era, the incidence of AIDS-defining cancers has decreased, while the incidence of non-AIDS defining cancers has increased; however, the existence of a relationship between benign or malignant schwannomas and AIDS remains unclear. Although a case of ethmoid malignant schwannoma in an AIDS patient was first reported in 1993, no additional reports of schwannomas associated with AIDS have been published since. In the current study, the case of a 30-year-old male AIDS patient with a large benign retroperitoneal schwannoma is presented. The ideal treatment of retroperitoneal schwannomas is complete excision. However, controversy exists over the necessity of negative soft tissue margins, particularly when adjacent tissue or viscera must also be removed. In the current case study, due to the immune dysfunction in AIDS patients, the incidence of malignancy could not be completely excluded prior to surgery and a significant risk of short-term relapse or malignancy following partial tumor resection was present. The patient underwent complete resection with partial superior mesenteric artery excision in order to attain negative margins, and recovered well. A follow-up was performed 1 year after the procedure and the patient was well and a CT scan demonstrated no evidence of recurrence. However, the long term efficacy of this procedure requires continued observation in this patient.