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L2椎体骨内神经鞘瘤——病例报告

Intraosseous neurilemmoma of L2 vertebra--a case report.

作者信息

Gupta S P, Agarwal Anil

机构信息

Department of Orthopaedics, S.M.S Medical College and associated Hospitals, Jaipur, Rajasthan.

出版信息

Indian J Pathol Microbiol. 2005 Jul;48(3):367-9.

Abstract

Intraosseous neurilemmoma (schwannoma) is a rare bone tumor with incidence less than 0.2% of all primary bone tumors. It is a benign neoplasm arising from the schwann cells of the nerve sheath. When they occur, they are usually found in the mandible. This paper reports an unusual occurrence of intraosseous neurilemmoma in L2 vertebral body. This patient presented with complaints of backache and progressively increasing weakness in both lower limbs. Roetengenograms showed an osteolytic lesion of L2 vertebra localized in the left half of the body and pedicle. Computed tomograph revealed a large soft tissue component of the tumor mass with thecal sac compression. A computed tomograph assisted needle biopsy revealed the tumor to be neurilemmoma. Subsequently, during decompression, it was possible to shell out tumor from surrounding tissues. Remaining tumor was curettedfrom bone and the cavity packed with autograft. The recovery was uneventful with incorporation of graft. The aim of this article is to highlight intraosseous neurilemmoma as a possible differential diagnosis in bony tumors. Intraosseous neurilemmoma of lumbar vertebrae is an extremely rare occurrence and till date only four cases are reported in English literature.

摘要

骨内神经鞘瘤是一种罕见的骨肿瘤,发病率不到所有原发性骨肿瘤的0.2%。它是一种起源于神经鞘雪旺细胞的良性肿瘤。当它发生时,通常位于下颌骨。本文报道了一例发生在L2椎体的不寻常骨内神经鞘瘤。该患者主诉背痛,双下肢无力逐渐加重。X线片显示L2椎体溶骨性病变,位于椎体左半侧及椎弓根。计算机断层扫描显示肿瘤肿块有一个大的软组织成分,压迫硬膜囊。计算机断层扫描辅助针吸活检显示肿瘤为神经鞘瘤。随后,在减压过程中,可以将肿瘤从周围组织中剥离出来。残留肿瘤从骨中刮除,骨腔用自体骨填充。移植骨融合后恢复顺利。本文的目的是强调骨内神经鞘瘤作为骨肿瘤可能的鉴别诊断。腰椎骨内神经鞘瘤极为罕见,迄今为止,英文文献中仅报道了4例。

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