Recurrent Malignant Peripheral Nerve Sheath Tumor encasing the uretera case report

54 yr male known case of retroperitoneal tumor, underwent enbloc excision of tumor (size20x15 cm) with Left partial nephrectomy on 18-2-2011. Biopsy reported as malignant peripheral nervesheath tumor (Gr.1), with negative margins. Now admitted with CO (Lt) Lower abdominal pain since 1month without urinary symptoms. Examination findings were unremarkable. On investigation- RFT-normal, USG - showed well defined hypoechoic mass lesion 5.5x4.5cm (Lt) iliac fossa, CECTABDrevealed 7.5x7.8x5.5cm well enhancing (Lt) retroperitoneal tumor with encasement of (Lt) mid ureterinfiltration of left psoas muscle. Laparotomy revealed 12x8 cm mass posterior to sigmoid mesocolon,adherent to iliac vessels, encasing mid ureter (Lt), Enbloc excision of tumor along with involved ureter (10cm) was done and resultant ureteric loss was managed by ureteroneocystostomy with long boariflap with 5Fr DJ stenting. Post.op period uneventful.This case is presented because of its rarepresentation. Despite partial nephrectomy having been done and long segment ureteric loss, thekidney was still salvaged using long Boari flap.