Petrovic J, Barisic G, Krivokapic Z
Clinic for Digestive diseases, First Surgical Clinic, Clinical Centre of Serbia, Belgrade, Serbia.
Chirurgia (Bucur). 2012 May-Jun;107(3):412-4.
Sacral schwannoma is a rare retrorectal tumor in adults. Postoperative sacral neurological deficit is difficult to avoid. Currently, there is no established consensus regarding best treatment options. We present a case of a 33 years old patient with atypical discomfort in lower abdomen and no neurological complaints who was diagnosed with a pelvic mass by abdominal ultrasound. CT, MRI and MSCT showed an inhomogeneous presacral mass involving right S1 sacral foramen. Although there were no neurological complaints, EMG and ENG showed a minor chronic lesion of L5 root bilaterally, more on the right side, affecting the fibers to the small muscles of the feet. We treated this patient with total extirpation of the mass without additional curretage. No radiotherapy was applied and postoperative neurological functions were preserved.
骶骨神经鞘瘤是成人罕见的直肠后肿瘤。术后骶神经功能缺损难以避免。目前,关于最佳治疗方案尚无既定共识。我们报告一例33岁患者,下腹部有非典型不适,无神经方面主诉,经腹部超声检查诊断为盆腔肿块。CT、MRI和MSCT显示骶前不均匀肿块累及右侧S1骶孔。尽管无神经方面主诉,但肌电图和神经电图显示双侧L5神经根有轻微慢性损伤,右侧更明显,影响到足部小肌肉的纤维。我们对该患者进行了肿块全切术,未进行额外刮除。未应用放疗,术后神经功能得以保留。