Kohyama Sho, Hara Yuki, Nishiura Yasumasa, Hara Tetsuya, Nakagawa Tanefumi, Ochiai Naoyuki
Dept, of Orthopaedic Surgery, University of Tsukuba, Graduate school of Comprehensive Human Sciences, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan.
J Brachial Plex Peripher Nerve Inj. 2011 Nov 1;6(1):9. doi: 10.1186/1749-7221-6-9.
We report the case of a patient who noticed muscle weakness in his left arm 5 years earlier. On examination, a biloculate mass was observed in the left supraclavicular area, and Tinel's sign caused paresthesia in his left arm. Magnetic resonance imaging showed a continuous, multinodular, plexiform tumor from the left C5 to C7 nerve root along the course of the brachial plexus to the left brachia. Tumor excision was attempted. The median and musculocutaneous nerves were extremely enlarged by the tumor, which was approximately 40 cm in length, and showed no response to electric stimulation. We resected a part of the musculocutaneous nerve for biopsy and performed latissimus dorsi muscle transposition in order to repair elbow flexion. Morphologically, the tumor consisted of typical Antoni A areas, and immunohistochemistry revealed a Schwann cell origin of the tumor cells moreover, there was no sign of axon differentiation in the tumor. Therefore, the final diagnosis of plexiform Schwannoma was confirmed.
我们报告了一例患者，该患者5年前注意到左臂肌肉无力。检查时，在左锁骨上区观察到一个双叶状肿块，Tinel征引起其左臂感觉异常。磁共振成像显示从左C5至C7神经根沿臂丛神经走行至左上肢有一个连续的、多结节的、丛状肿瘤。尝试进行肿瘤切除。正中神经和肌皮神经被肿瘤极度扩大，肿瘤长度约40 cm，对电刺激无反应。我们切除了部分肌皮神经进行活检，并进行背阔肌移位以修复屈肘功能。形态学上，肿瘤由典型的Antoni A区组成，免疫组化显示肿瘤细胞起源于施万细胞，此外，肿瘤内无轴突分化迹象。因此，确诊为丛状神经鞘瘤。
