De Cerchio Leonardo, Contratti Filiberto, Fraioli Mario F
Division of Neurosurgery, Department of Neuroscience, Tor Vergata Hospital, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy.
Eur Spine J. 2006 Oct;15 Suppl 5(Suppl 5):664-9. doi: 10.1007/s00586-006-0205-x. Epub 2006 Sep 1.
The schwannomas are benign tumors originating from Schwann cells which constitute the nerve sheath. The dorsal pigmented type of schwannomas is relatively rare (Goldstein in Am J Med Genet 86:62-65, 2004; Kurtkaya-Yapicier in Histol Histopathol 18(3):925-934, 2003). There are two distinct types of melanotic schwannoma: the sporadic melanotic schwannomas and the psammomatous melanotic schwannomas of Carney complex. We report a case of a patient harboring a right dorsal dumb-bell melanotic schwannoma and left adrenal mass. The patient underwent a surgical procedure for en bloc total removal of the mass by a posterior and anterior approach. Histopathological examination revealed the diagnosis of melanotic schwannoma. At present, we have no reliable marker of histopathological malignancy of melanotic schwannoma so the follow-up period ought to continue for a period of more than 5 years. As the total removal of the melanotic neurinomas is mandatory to prevent possible malignant transformation of the tumor recurrence or regrowth, we believe that the posterior and trans-thoracic approach are the most suitable one for the dorsal dumb-bell schwannoma.
施万细胞瘤是起源于构成神经鞘的施万细胞的良性肿瘤。背侧色素沉着型施万细胞瘤相对少见（戈尔茨坦，《美国医学遗传学杂志》86:62 - 65，2004年；库尔卡亚 - 亚皮西尔，《组织学与组织病理学》18(3):925 - 934，2003年）。黑色素性施万细胞瘤有两种不同类型：散发性黑色素性施万细胞瘤和卡尼综合征的砂粒体性黑色素性施万细胞瘤。我们报告一例患者，其患有右侧背侧哑铃状黑色素性施万细胞瘤和左侧肾上腺肿块。该患者接受了通过前后联合入路整块完整切除肿块的手术。组织病理学检查确诊为黑色素性施万细胞瘤。目前，我们没有黑色素性施万细胞瘤组织病理学恶性程度的可靠标志物，因此随访期应持续超过5年。由于必须完整切除黑色素性神经鞘瘤以防止肿瘤复发或再生长可能发生的恶性转化，我们认为后入路和经胸入路是治疗背侧哑铃状施万细胞瘤最合适的方法。
