Solitary Huge Retroperitoneal Benign Neurofibroma: A Rare Case Report

Background Huge retroperitoneal neurofibroma is very uncommon diagnosis. They are rare growths that occur in the retroperitoneal space and are found in 3–5% of all cases of Neurofibromas. Case Presentation We present a case of huge retroperitoneal benign neurofibroma in a 65 years old female patient who presented with progressive swelling to the abdomen, mild lower back pain and intermittent discomfort of 8 years duration with no other remarkable medical or surgical history. On abdominal examination, she had about 30*35 CM firm to hard, non-tender mass. Abdominal CT scan shows large lobulated intra-abdominal mass about 30*28*23 CM with heterogenous enhancement. Laparotomy was done and about 35*25 CM lobulated mass originating in the retroperitoneum was found and excised completely. Histopathology was suggestive of benign spindle cell type neurofibroma. Discussion Retroperitoneal neurofibromas are rare and can present a diagnostic and therapeutic problem primarily because of their infiltrative nature and the ability to compress adjacent structures. They present clinically when they attains considerable size or invade or compress neighboring organs and tissues. Our case has long standing history of slowly increasing abdominal mass with negligible discomfort. Preoperative imaging via CT offers a non-invasive method to definitively diagnose retroperitoneal neurofibromas and almost all reported cases were managed with surgery with no recurrence in their follow up. Conclusion This case highlights the rarity of benign retroperitoneal neurofibromas without neurofibromatosis and underscores the importance of maintaining a high index of suspicion for such tumors in adults with long standing swelling to the abdomen.