Shih Y-C, Chen Y-L, Fang H-Y, Wu C-Y, Lin Y-C, Lin Y-M
School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Republic of China.
Thorac Cardiovasc Surg. 2009 Oct;57(7):436-9. doi: 10.1055/s-2008-1038984. Epub 2009 Sep 30.
Thoracic neurogenic tumors typically originate from the posterior mediastinum and the intercostal nerves. No report of a chest wall schwannoma extending toward the subphrenic areas and making a significant indentation into liver parenchyma exists to date. We present a liver tumor-mimicking schwannoma of the intercostal nerves. A 58-year-old woman presented with a painful lesion in the right subphrenic area and abdominal pain in the right upper quadrant for two months. Abdominal ultrasonography and magnetic resonance imaging revealed a tumor, 9.1 x 7.1 x 8.9 cm in size, with an inner cystic change in segment V and VI of the liver. The tumor was completely resected together with part of the 9th rib. Pathology confirmed a schwannoma and showed a tumor composed of spindle cells with oval to wavy nuclei. The patient was still asymptomatic at follow-up after 36 months, with no sign of recurrence.
胸段神经源性肿瘤通常起源于后纵隔和肋间神经。迄今为止，尚无关于胸壁神经鞘瘤延伸至膈下区域并对肝实质造成明显压迹的报道。我们报告一例酷似肝脏肿瘤的肋间神经鞘瘤。一名58岁女性因膈下右侧区域疼痛性病变及右上腹腹痛2个月就诊。腹部超声和磁共振成像显示肝脏Ⅴ段和Ⅵ段有一个大小为9.1×7.1×8.9 cm的肿瘤，内部有囊性改变。该肿瘤与第9肋的一部分一起被完整切除。病理证实为神经鞘瘤，显示肿瘤由具有椭圆形至波浪状核的梭形细胞组成。患者在36个月的随访中仍无症状，无复发迹象。
