Schwannoma in Hemophilic Patient: Surgical Considerations

Abstract
Introduction: Schwannoma is a benign, encapsulated, tumor that arises from Schwann cells of myelinated nerves. In this report, we present a case of schwannoma in a hemophilic patient and its surgical considerations related to bleeding complications. Case Presentation: We present a case of a 27-year-old male coming to our center with a chief complaint of a painless, non-progressive growing mass on the back of his head since a year prior to admission. Physical examination showed that the mass was mobile, firm, and had a welldefined margin beneath the scalp. His radiograph showed a soft tissue mass beneath the scalp. MRI demonstrated a dense-multilobulated mass without intracranial infiltration. The patient had hemophilia A from the age of 5. We performed marginal excision of the mass with regiments of factor VIII (FVIII) concentrates preoperatively, intraoperatively, and postoperatively. Pathology was consistent with schwannoma.Conclusions: Schwannoma management in hemophilic patients needs several considerations. Perioperative planning plays a major part in the management of patients with tumors and hemophilia to prevent bleeding complications.