Qin Sida, Yang Chengcheng, Ren Hong
First Affiliated Hospital, Xi'an Jiaotong University, Faculty of Medicine, Departments of Thoracic Surgery, Xi'an, P.R. China.
Turk Neurosurg. 2013;23(2):245-8. doi: 10.5137/1019-5149.JTN.4091-11.1.
Schwannoma is a benign nerve sheath tumor composed of Schwann cells. A solitary schwannoma in the thorax is not rare, but a patient with Neurofibromatosis type 2 (NF2) and multiple thoracic schwannomas is extremely rare. We report the case of a 27-year-old woman with NF2 and two large schwannomas in her mediastinum and chest wall. We performed thoracic surgery on the patient, but she developed a cerebral hernia immediately after the operation. We report this case in order to analyze the relationship between the operation and cerebral hernia and find a way to prevent this consequence in the future. We conclude that a cranial MRI must be performed for patients with multiple thoracic schwannomas before the surgery. If there is a tumor inside the cranium, the disease in the brain must be treated first to prevent the occurrence of cerebral hernia or hemorrhage.
施万细胞瘤是一种由施万细胞组成的良性神经鞘瘤。孤立性胸段施万细胞瘤并不罕见,但患有2型神经纤维瘤病(NF2)且有多发性胸段施万细胞瘤的患者极为罕见。我们报告一例27岁患有NF2的女性病例,其纵隔和胸壁有两个大的施万细胞瘤。我们对该患者进行了胸外科手术,但她在术后立即出现了脑疝。我们报告此病例以分析手术与脑疝之间的关系,并寻找未来预防这种后果的方法。我们得出结论,对于有多发性胸段施万细胞瘤的患者,术前必须进行头颅磁共振成像(MRI)检查。如果颅骨内有肿瘤,必须先治疗脑部疾病以防止脑疝或出血的发生。