Przyodbytnicza torbiel olbrzymia o utkaniu neurofibroma – opis przypadku

*Jacek Bierca¹, Małgorzata Kołodziejczak², Anna Kosim³

Summary
Neurofibroma is a benign tumor, derived from Schwann cells, it can have various sizes, from small nodules, through large tumors deforming the body at the point of location, uncommonly (from 1-5%) it may also undergo malignant transformation. The location around the rectum is casuistic, individual cases of neurofibromas at this location are described in the literature. The article presents a case of a 41-year-old man admitted for elective surgery because of a large tumor in the left buttock, initially assessed as a lipoma. Retroperitoneal perianal cyst excision was carried out. During the procedure, there was a damage to the rectal wall, which was sutured. Complete antibiotic therapy was administered to the patient: Claforan, Metronidazole and Amikin. Histopathological examination revealed a large neurofibroma with the characteristics of mucinous degeneration and edema, focally encapsulated tumor, growing into the muscle tissue. The postoperative course was good but, due to a leakage of the wound in the rectum, the patient was offered stoma resection, the patient did not consent and, in general good condition, was discharged home on the 9^th day. After a month, the patient came for a follow-up check, completely healed with normal continence.
Conclusions. 1. Operations of anal tumors of significant sizes should be preceded by diagnostic imaging examinations which enable determining precise anatomical boundaries of the tumor and reducing the risk of intraoperative complications. 2. Removing anal tumors should take into account unusual histopathological texture, among others, tumors that come out of the encapsulated nerve fibers.

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