头颈部神经鞘瘤:有趣的病例系列与文献回顾

Z. Teli, Shehnaz R. Kantharia, Aayushi Kantharia, R. Kantharia
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摘要

神经鞘瘤是一种良性的、包膜的、生长缓慢的外周神经鞘肿瘤,由雪旺细胞引起。25-40%的神经鞘瘤发生在头颈部,其中1-12%发生在口腔。口腔中最常见的凹陷是舌头,其次是腭和颊粘膜。最常见的受累神经包括舌下神经、舌神经、鼓室神经、舌咽神经、迷走神经和喉上神经。常见的表现是无痛结节或肿胀,具体取决于表现部位。神经鞘瘤的术前诊断通常由细针抽吸细胞学(FNAC)提出,并通过组织病理检查予以证实。通过超声扫描、计算机断层扫描(CT)或磁共振成像(MRI)形式的成像来描绘范围、确切位置以及与周围结构的关系。然而,MRI是首选的成像方式,因为它可以精确地提供更好的软组织细节以及起源神经。手术切除是首选的治疗方法。复发是微不足道的,恶性转化的机会非常罕见。
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Head and Neck Schwannomas: Interesting Case Series with Review of Literature
Schwannoma is a benign, encapsulated and a slowly growing peripheral neural sheath tumor that arises from the schwann cells. 25-40% of Schwannomas occur in the head and neck region and of which 1-12% are seen in the oral cavity. The most common subsite in the oral cavity is tongue followed by the palate and buccal mucosa. The most commonly involved nerves include hypoglossal, lingual, tympanic, glossopharyngeal, vagus and the superior laryngeal nerves. The common presentation is a painless nodule or a swelling depending on the site of presentation. The preoperative diagnosis of schwannoma is usually suggested by Fine Needle Aspiration Cytology (FNAC) and is confirmed by histo-pathologic examination. The extent, exact location and relation with surrounding structures is delineated by imaging in the form of Ultrasound scanning, Computed Tomography (CT) scan or an Magnetic Resonance Imaging (MRI). However, MRI is the imaging modality of choice as it provides better soft tissues details with precision along with the nerve of origin. Surgical excision is the treatment of choice. Recurrence is insignificant and has very rare chances of malignant transformation.
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