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Recently,‌imaging‌studies‌have‌markedly‌improved‌the‌preoperative‌diagnostic‌accuracy.‌However,‌the‌intraoperative‌ diagnosis‌differs‌from‌the‌preoperative‌diagnosis‌in‌certain‌cases.‌We‌report‌a‌case‌of‌retroperitoneal‌schwannoma‌that‌ was‌preoperatively‌diagnosed‌as‌an‌ovarian‌tumor,‌wherein‌the‌tumor‌location‌was‌determined‌by‌laparoscopy‌and‌the‌ application‌of‌pressure‌on‌the‌abdominal‌wall.‌A‌48-year-old‌woman‌(gravida:‌3,‌para:‌3)‌presented‌with‌lower‌abdominal‌ discomfort.‌Ultrasonography‌and‌magnetic‌ resonance‌ imaging‌ (MRI)‌ indicated‌ the‌presence‌of‌bilateral‌multicystic‌ ovarian‌tumors‌in‌her‌right‌and‌left‌ovaries‌(diameters:‌75‌mm‌and‌31‌mm,‌respectively).‌Hence,‌she‌was‌referred‌to‌our‌ hospital‌for‌treatment.‌Although‌the‌right‌ovarian‌tumor‌could‌be‌clearly‌observed‌by‌transvaginal‌ultrasonography,‌the‌ left‌ovarian‌tumor‌could‌not‌be‌ identified‌due‌to‌ its‌relatively‌smaller‌size.‌Laboratory‌values,‌ including‌the‌ levels‌of‌ CA19-9,‌CA125,‌ and‌CEA,‌were‌normal.‌Nevertheless,‌ she‌was‌diagnosed‌as‌having‌bilateral‌ ovarian‌ tumors,‌ and‌ laparoscopic‌surgery‌was‌performed‌ for‌ treatment.‌Laparoscopic‌observation‌ indicated‌a‌75-mm‌tumor‌ in‌ the‌right‌ ovary,‌but‌ showed‌normal‌ appearance‌of‌ the‌ left‌ ovary.‌After‌ laparoscopic‌bilateral‌ salpingo-oophorectomy‌was‌ performed,‌as‌the‌left‌ovary‌tumor‌diagnosed‌on‌preoperative‌MRI‌remained‌unidentified,‌pressure‌was‌applied‌on‌the‌ abdominal‌wall‌ adjacent‌ to‌ the‌ site‌where‌ the‌ left‌ ovary‌ tumor‌was‌ suspected,‌ and‌ the‌ site‌was‌ laparoscopically‌ observed.‌Accordingly,‌a‌retroperitoneal‌schwannoma‌was‌accurately‌identified,‌and‌was‌completely‌resected‌thereafter‌ via‌laparotomy‌with‌a‌minimal‌incision.‌The‌histological‌diagnosis‌was‌schwannoma‌of‌the‌femoral‌nerve.‌

Locating a retroperitoneal tumor through the application of pressure on the abdominal wall under laparoscopy