A case report of a large gluteal schwannoma with pelvic extension

Benign schwannomas are slow-growing, painless tumours originating from Schwann cells, which form the sheaths of peripheral nerves. These tumours are relatively rare, with an incidence of 1-3 cases per 100,000 individuals annually. While they are most commonly found in the head, neck, and spine, schwannomas can also occur in the extremities, particularly in the upper limbs. Tumours in the pelvis and gluteal region are less frequent but are clinically significant due to their potential to compress adjacent structures. We present a case of a 74-year-old male patient who underwent surgery for a large schwannoma in the gluteal region, extending into the pelvis at the level of the piriformis muscle and sciatic foramen. Initially misdiagnosed and treated as sciatica, this case highlights the importance of considering schwannomas in the differential diagnosis of patients presenting with neurological symptoms in unusual locations. Sciatic symptoms that do not respond to conservative treatment should be further investigated, and a thorough palpation of tender and painful points should always be performed to aid in the potential diagnosis of a local soft tissue tumour.