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Common reasons for an imbalanced ratio between phosphatidylcholine and cholesterol include: Fasting Overeating High-fat diet Ketogenic diet Vegan diets Protein deficiency Low dietary choline intake Low dietary glycine intake Methylation disregulation Dirty MTHFR Dirty PEMT Dehydration Low stomach acid Ongoing intake of proton pump inhibitors (PPIs) Bacterial overgrowth of specific bacteria such as certain Clostridia species What Happens When You Dont Have Healthy Bile Composition or Bile Flow

doi: 10.3171/2023.8.SPINE23427 Summary Keywords melanotic schwannoma(MS), retroperitoneal schwannoma, malignant melanotic nerve sheath tumor(MMNST), rare giant tumor, surgical resection Citation Chen P, Cheng J and Zhang L (2024) Rare giant retroperitoneal melanotic schwannoma: a case report and literature review

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