Gündes Hakan, Tosun Bilgehan, Müezzinoglu Bahar, Alici Tugrul
Department of Hand Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey.
J Peripher Nerv Syst. 2004 Sep;9(3):190-2. doi: 10.1111/j.1085-9489.2004.09307.x.
Schwannomas are common benign nerve tumors occurring in the peripheral nerves. A very large schwannoma of more than 5 years duration, originating from the median nerve in the carpal tunnel in a 38-year-old woman, is reported. There was a painful mass, 60 mm in length and 42 mm in diameter, on the palm without signs of sensory disturbance or atrophy on the thenar muscles. Surgical removal was performed under high-power magnification by separating the sensory and motor fascicles from the tumor. Histological examination resulted in a Schwannoma. At 4-year follow-up, the patient was asymptomatic with excellent relief of symptoms. The tumor did not recur. Although cases have been reported in the literature, this is one of the largest ever described without any neurologic deficit.
施万细胞瘤是常见的发生于周围神经的良性神经肿瘤。本文报道了一例病程超过5年的巨大施万细胞瘤,患者为一名38岁女性,肿瘤起源于腕管内的正中神经。患者手掌有一疼痛性肿块,长60mm,直径42mm,无感觉障碍体征,鱼际肌无萎缩。在高倍放大下进行手术切除,将肿瘤的感觉和运动束分离。组织学检查确诊为施万细胞瘤。随访4年,患者无症状,症状得到极佳缓解。肿瘤未复发。尽管文献中已有病例报道,但这是所描述的最大的病例之一,且无任何神经功能缺损。