Gastrointestinal bleeding as a first symptom of a focal jejunal amyloidosis.

Immunohistology studies play an essential role in the diagnosis and in this type of tumors they are positive for S100 (family of low-molecular weight proteins present in the cells derived from the neural crest) and vimentin (protein found in the cytoskeleton of mesenchymal cells). As for the treatment of suprarenal tumors, surgery is indicated in functioning tumors, in masses with radiological suspicion for malignancy (regardless of size) and in tumors larger than 4 cm, as in our case. Size is the most important criterion for the indication for surgery in non-functioning tumors. Laparoscopic removal is the technique of choice due to its limited postoperative morbidity and the existence of adequate planes outlining the mass. In our case, the lymph node location of the schwannoma was not able to be identified before the histopathology study since, on the imaging techniques as well as macroscopically after the removal of the specimen, it formed part of a mass that was integrated with the suprarenal gland. In conclusion, suprarenal lymph node schwannomas are uncommon neoplasms, although they should be taken into consideration in the differential diagnosis of retroperitoneal masses.