PMC3964667_01
Cystic schwannoma imaging: Ultrasonography of the urinary bladder showed the cystic space occupying lesion (SOL) with multiple septations (a). Computed tomography of the abdomen showed a well defined cystic SOL (11cm x 8cm x 7cm) with multiple areas of focal calcification in the wall. The bladder and the rectum were pushed to the right (b). Coronal sections demonstrated the SOL to be intricately related to the left psoas muscle (c). There was bilateral hydroureteronephrosis (d).
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Ultrasonography of the abdomen revealed a cystic mass with thin septations located between the bladder and rectum (Fig 1a). There was bilateral hydroureteronephrosis (Figs 1b-d).
Cystic schwannoma: The mass as seen on laparoscopy (arrow) with the left iliac vessels (dotted arrow) (a). The mass was dissected from the left iliac vessels (b). The gross specimen revealed multiple septations and focal areas of calcification in the wall (c). Microscopic examination (haematoxylin and eosin stain, 10x magnification) revealed the elongated, spindle shaped cells with prominent nuclei arranged in a palisading manner with Antoni A and Antoni B patterns suggestive of a schwannoma (d).
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Four trocars were inserted below the umbilicus in an inverted U fashion and laparoscopy was performed with a 30  scope (Fig 2a). The mass was adherent to the left iliac vessels and could only be dissected with difficulty (Fig 2b). The cut section of the tumour showed a cystic mass with areas of calcification (Fig 2c). There were no mitotic figures (Fig 2d).