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腹腔镜下切除腹膜后神经鞘瘤。

Laparoscopic resection of a retroperitoneal schwannoma.

作者信息

Asakage N

机构信息

Department of Surgery, Kashiwa Kousei General Hospital, Chiba, Japan.

出版信息

Asian J Endosc Surg. 2012 Feb;5(1):25-30. doi: 10.1111/j.1758-5910.2011.00108.x.

Abstract

Herein is a report of a case of a 34-year-old man whose chief complaint was right lower abdominal pain. He was diagnosed with acute appendicitis. Additionally, an abdominal CT scan found retroperitoneal tumor approximately 5 cm in size, with an imaging effect, located adjacent to the dorsal side of the inferior vena cava. For this suspected neurogenic tumor, laparoscopic appendectomy and retroperitoneal tumorectomy were performed after conservative treatment of appendicitis. The retroperitoneal tumor was 5.5 × 3.5 cm in size, had a capsule, smooth surface and soft elasticity, and the divided face was solid white. The histopathological work-up revealed that the tumor was a benign mixed-type schwannoma, in which spindle cells were arranged. The patient's postoperative course was uneventful, and he was discharged from the hospital 7 days after the surgery. In general, retroperitoneal schwannoma is not associated with any symptoms, so it is often discovered accidentally, as in this case. The appropriate treatment for the condition is surgical resection of the tumor including the capsule. However, the use of laparoscopic surgery has been reported in recent years. Although the majority of the cases are benign, there have been some reports of local recurrence. As such, this case will required careful follow-ups.

摘要

本文报告一例34岁男性病例,其主要症状为右下腹痛。他被诊断为急性阑尾炎。此外,腹部CT扫描发现一个大小约5厘米的腹膜后肿瘤,具有影像学特征,位于下腔静脉背侧附近。对于这个疑似神经源性肿瘤,在对阑尾炎进行保守治疗后,进行了腹腔镜阑尾切除术和腹膜后肿瘤切除术。腹膜后肿瘤大小为5.5×3.5厘米,有包膜,表面光滑,质地柔软,切面为实性白色。组织病理学检查显示,该肿瘤为良性混合型神经鞘瘤,其中有梭形细胞排列。患者术后恢复顺利,术后7天出院。一般来说,腹膜后神经鞘瘤无任何症状,因此常像本病例一样意外发现。该病的适当治疗方法是手术切除肿瘤包括包膜。然而,近年来有腹腔镜手术应用的报道。虽然大多数病例是良性的,但也有一些局部复发的报道。因此,该病例需要密切随访。

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