Neurofibroma invading into urinary bladder presenting with symptoms of obstructed defecation and a large perineal hernia

BMC Surgery

Dharmabandhu N Samarasekera¹  Neville D Perera³  Chandu De Silva²  Chathuranga Tisara Keppetiyagama¹  Duminda Subasinghe¹ 

[1] The National Hospital of Sri Lanka, University Surgical Unit, Colombo, Sri Lanka;Department of Pathology, University of Colombo, Colombo, Sri Lanka;Department of Urology and renal transplant, The National Hospital of Sri Lanka, Colombo, Sri Lanka

关键词: Perineal hernia;    Obstructive defecation;    Multiple neurofibromatosis;   

Others  :  866851
DOI  :  10.1186/1471-2482-14-21

 received in 2013-11-13, accepted in 2014-04-08,  发布年份 2014

【 摘 要 】

Background

Pelvic floor hernias pose a diagnostic and a treatment challange. Neurofibromatosis is a rare systemic disease, and urinary tract involvement is rare.

Case presentation

Here we report a case of a 54-year-old female with multiple neurofibromatosis who presented with features of obstructed defecation and was found to have a large perineal hernia. At surgery, we found an unusual herniation of a large neuropathic bladder and rectum through a perineal defect. She underwent reduction cystoplasty and repair of the pelvic floor using a prolene mesh. Subsequent histopathological examination confirmed a large neurofibroma infiltrating the urinary bladder.

Conclusion

Neurofibromatosis of the bladder is rare it should be considered as a differential diagnosis in patients presenting with symptoms of obstructed defecation.

【 授权许可】

   
2014 Subasinghe et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Preiss A, Herbig B, Do¨ rner A: Primary perineal hernia: a case report and review of the literature. Hernia 2006, 10(5):430-433.
• [2]Yeoman FC: Levator hernia perineal and pudendal. Am J Surg 1939, 43:695-697.
• [3]Stamatiou D, Skandalakis JE, Skandalakis LJ, Mirilas P: Perineal Hernia: surgical anatomy, embryology, and technique of repair. Am Surg 2010, 76(5):474-479.
• [4]Weiss SW, Goldblum JR: Benign tumors of peripheral nerves. In Enzinger and Weiss’s soft tissue tumors. 4th edition. Edited by Strauss M. St Louis,Missouri: Mosby; 2001:1126-1146.
• [5]Riccardi VM, Eichner JE: Neurofibromatosis:Phenotype natural history and pathogenesis. Baltimore: Johns Hopkins University Press; 1986.
• [6]Ishii S, Han S, Shiiba K, Mizoi T, Okabe M, Horii A, Nagura H, Matsuno S, Sasaki I: Allelic loss of the NF1 gene in anal malignant melanoma in a patient with neurofibromatosis type 1. Int J Clin Oncol 2001, 6(4):201-204.
• [7]Rastogi R: Intra-abdominal manifestation of vonRecklinghausen’s neurofibromatosis. Saudi J Gastroenterol 2008, 14:80-82.
• [8]Gerhardt C: Zur diagnostik multipler neurobildung. Dtsch Arch Klin Med 1878, 21:268.
• [9]Hintsa A, Lindell O, Heikkila P: Neurofibromatosis of the bladder, case report. Scand J Urol Nephrol 1996, 30:497-499.
• [10]Hulse CA: Neurofibromatosis: bladder involvement with malignant degeneration. J Urol 1990, 144:742-743.
• [11]Rober PE, Smith JB, Sakr W, Pierce JM: Malignant peripheral nerve sheath tumour (malignant schwannoma) of urinary bladder in von Recklinghausen neurofi-bromatosis. Urology 1991, 38:473-476.
• [12]Dahm P, Manseck A, Flossel C, Saeger HD, Wirth M: Malignant neurofibroma of the urinary bladder. Eur J Urol 1995, 27:261-263.
• [13]Salameh JR: Primary and unusual abdominal wall hernias. Surg Clin N Am 2008, 88(1):45-60.
• [14]Lubat E, Gordon RB, Birnbaum BA, Megibow AJ: CT diagnosis of posterior perineal hernia. AJR Am J Roentgenol 1990, 154(4):761-762.