小腿微囊/网状神经鞘瘤:1例报告并文献复习

Tsuyoshi Saito, Daisuke Kubota, Keita Sasa, Nobuhiko Hasegawa, T. Hayashi, T. Takagi, M. Ishijima
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摘要

微囊性/网状神经鞘瘤是神经鞘瘤的一种独特的组织病理学变异,非常罕见。它发生在下肢皮下软组织很少被报道。病例报告:我们报告一个微囊/网状神经鞘瘤产生于皮下病变的小腿,33岁的男性。患者入院前6个月发现右下肢皮下肿块,左下肢放射痛。mri示右小腿皮下一清晰肿块,最大直径11 mm, t1低信号,t2高信号。组织学检查显示肿瘤周围有一个细胞区,尽管大多数肿瘤在黏液-胶原基质内表现为微囊/网状结构。目前的病例包膜良好,没有表现出浸润性生长模式。此外,泡沫状巨噬细胞聚集是常见的,尽管这是一种罕见的特征。手术切除完整,切除边缘干净,患者情况良好,术后14个月随访无肿瘤复发迹象。结论:尽管经典Antoni A区有助于微囊/网状神经鞘瘤的诊断,但本病例微囊/网状神经鞘瘤的少见表现。
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Microcystic/reticular schwannoma of the lower leg: Case report with review of literature
Introduction: Microcystic/reticular schwannoma is a distinctive histopathological variant of schwannoma, which is rare. Its occurrence in the subcutaneous soft tissue of the lower extremity has rarely been reported. Case Report: We report a microcystic/reticular schwannoma arising from a subcutaneous lesion on the lower leg of a 33-year-old man. The patient noticed a subcutaneous mass on the right lower leg six months before admission and experienced radiation pain in the left lower leg. Magnetic resonance imaging revealed a well-demarcated mass with 11-mm maximum diameter with low signal intensity on T1-weighted imaging and high signal intensity on T2-weighted imaging in the subcutaneous region of the right lower leg. Histological examination revealed a cellular area at the periphery of the tumor, although the majority of the tumor showed a microcystic/reticular structure within the myxo-collagenous stroma. The current case was well capsulated and did not show an infiltrative growth pattern. In addition, aggregation of foamy macrophages was frequently seen, although it was reported as a rare feature. After complete surgical excision with clean resection margins, the patient is well, with no evidence of tumor recurrence on follow-up after postoperative 14 months. Conclusion: In this case, infrequent findings for microcystic/reticular schwannoma were observed, although the presence of the classical Antoni A area was helpful for the diagnosis of microcystic/reticular schwannoma.
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