Kraus E, Braunsdorf W E, Klinge H, Jensen J P
Neurochirurgische Universitätsklinik Kiel.
Neurochirurgia (Stuttg). 1990 Oct;33 Suppl 1:65-8. doi: 10.1055/s-2008-1053602.
We report on diagnosis, treatment and clinical course of a solitary schwannoma of the trigeminal nerve with consecutive metastatic spread in a 45-year-old woman. The patient presented a temporal lobe syndrome with psychomotor seizures. Trigeminal nerve function was intact apart from a transient hypaesthesia in the mandibular branch. Assuming a meningioma the tumor was removed via a temporal approach. Secondary to the definitive histological diagnosis radiation therapy was performed. After that the patient was symptom-free. 4 months later a large recurrent tumor was found involving the cavernous sinus and the pterygopalatine fossa. In a second operation the tumor was resected intra- and extradurally through an infratemporal preauricular approach in cooperation with an oral and maxillo-facial surgeon. At this time multiple pulmonary metastases developed showing no response to polychemotherapy (EVI). The patient died 13 months after onset of the disease. Hitherto, only 5 cases of a primary malignant schwannoma of the trigeminal nerve have been published in the world literature.
我们报告了一名45岁女性患有三叉神经孤立性神经鞘瘤并伴有连续性转移扩散的诊断、治疗及临床病程。该患者表现为伴有精神运动性癫痫发作的颞叶综合征。除下颌支有短暂感觉减退外，三叉神经功能完好。最初假定为脑膜瘤，通过颞部入路切除肿瘤。在明确组织学诊断后进行了放射治疗。此后患者无症状。4个月后发现一个巨大的复发性肿瘤，累及海绵窦和翼腭窝。在第二次手术中，与口腔颌面外科医生合作，通过颞下耳前入路在硬膜内和硬膜外切除肿瘤。此时出现了多发肺转移，对多药化疗（EVI）无反应。患者在疾病发作13个月后死亡。迄今为止，世界文献中仅发表了5例原发性三叉神经恶性神经鞘瘤病例。
