Müller Andreas, Förster Gerhard, Behrendt Werner, Kosmehl Hartwig
ENT Department, Friedrich-Schiller University, Jena, Germany.
Acta Otolaryngol. 2002 Jul;122(5):565-8. doi: 10.1080/00016480260092426.
Ganglioneuromas are rare benign neurogenous neoplasms. The clinical symptoms of ganglioneuromas of the neck are usually mild and non-specific and definitive diagnosis requires a histological examination. We present the case of a 35-year-old female who complained of retroauricular pain as her first symptom and who was initially diagnosed with migraine. ENT examination revealed a bulging of the left pharyngeal wall. Fine-needle aspiration biopsy was misleading in terms of diagnosis. Histology after extirpation showed a ganglioneuroma. Ganglion cell differentiation was proven using the new intermediate filament class alpha-internexin immunohistochemical staining technique. Headache is an uncharacteristic symptom of ganglioneuroma and an interdisciplinary approach is required to find a possible cause. Periauricular pain without abnormal otoscopic findings should lead the otorhinolaryngologist to consider a retropharyngeal condition, especially if combined with dysphagia. Complete resection of the tumor using modern microsurgical techniques is the best way to extract ganglioneuroma today.
神经节瘤是一种罕见的良性神经源性肿瘤。颈部神经节瘤的临床症状通常较为轻微且不具有特异性，明确诊断需要进行组织学检查。我们报告一例35岁女性病例，该患者以耳后疼痛为首发症状，最初被诊断为偏头痛。耳鼻喉科检查发现左侧咽壁膨出。细针穿刺活检在诊断方面具有误导性。切除术后的组织学检查显示为神经节瘤。使用新的中间丝α-中间连接蛋白免疫组织化学染色技术证实了神经节细胞分化。头痛是神经节瘤不典型的症状，需要采用多学科方法来寻找可能的病因。耳镜检查无异常发现的耳周疼痛应促使耳鼻喉科医生考虑咽后病变，尤其是伴有吞咽困难时。采用现代显微外科技术完整切除肿瘤是目前切除神经节瘤的最佳方法。
