Chan Peter T, Tripathi Sankalp, Low Su E, Robinson Lee Q
Surgical Directorate, Warrington Hospital, Lovely Lane, Warrington, UK.
BMC Urol. 2007 Jan 23;7:1. doi: 10.1186/1471-2490-7-1.
Scrotal schwannoma is a rare neoplasm and poses a diagnostic challenge to urologists. This article describes a rare case of ancient scrotal schwannoma and reviews the current modality of investigation and treatment of this tumour.
A 28 year old man presented with a 3-month history of an asymptomatic scrotal swelling. Ultrasonography and computer topography revealed an intra-scrotal and extra-testicular mass without local invasion. Surgical excision was undertaken and histology was an ancient schwannoma of the scrotum.
Schwannoma is a benign encapsulating neoplasm with an overall low incidence, occurring mostly in the head and neck region and seldom in the scrotum. Histology shows two distinctive patterns, Antoni type A and B areas. Variations of schwannoma such as cellular, ancient, glandular and epithelioid are observed based on the appearances. Ancient schwannoma exhibits pleomorphism without mitosis as the result of cellular degeneration, which can lead to an erroneous diagnosis of malignancy. Imaging modalities are non-specific for schwannomas, but can define tumour size, site and extension. The mainstay treatment is complete excision, although local recurrence may occur in large and incompletely excised lesions. Malignant change is exceedingly rare.
阴囊神经鞘瘤是一种罕见的肿瘤，给泌尿外科医生带来诊断挑战。本文描述了一例罕见的陈旧性阴囊神经鞘瘤病例，并回顾了目前该肿瘤的检查和治疗方式。
一名28岁男性，有无症状阴囊肿胀3个月病史。超声检查和计算机断层扫描显示阴囊内睾丸外肿块，无局部侵犯。进行了手术切除，组织学检查为阴囊陈旧性神经鞘瘤。
神经鞘瘤是一种良性包膜肿瘤，总体发病率较低，主要发生在头颈部区域，很少发生在阴囊。组织学表现为两种不同的类型，即Antoni A型和B型区域。根据外观可观察到神经鞘瘤的不同变异，如细胞型、陈旧型、腺型和上皮样型。陈旧性神经鞘瘤由于细胞变性而表现出多形性且无有丝分裂，这可能导致误诊为恶性肿瘤。影像学检查对神经鞘瘤不具有特异性，但可确定肿瘤大小、位置和范围。主要治疗方法是完整切除，尽管在大的和切除不完全的病变中可能会发生局部复发。恶性变极为罕见。
