[Surgical treatment of retroperitoneal presacral large schwannoma by the anterior transabdominal approach: two cases reports].

Retroperitoneal schwannomas are relatively rare. However, when the tumors occur, they can be large and difficult to diagnose at an early stage because of their vague symptoms. Although surgery is the only treatment, the choice of surgical approach depends upon pathological type, the degree of sacral destruction, and intrapelvic extension. If a large component is present presacrally, an anterior transabdominal approach should be chosen to gain control of the tumor bleeding. We report two cases of large schwannoma in the retroperitoneal presacral space that was removed by the anterior transabdominal approach. We performed an intracapsular piecemeal resection with preservation of the tumor capsule, and were able to remove the tumor gross totally without any postoperative deficit. For this reason, we think that retroperitoneal presacral larger schwannoma should be removed leaving the capsule intact and using the anterior transabdominal approach to prevent injury of the adjacent structures.