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继发于胫后神经鞘瘤的跗管综合征

Tarsal tunnel syndrome secondary to schwannoma of the posterior tibial nerve.

作者信息

Hallahan Katrina, Vinokur Jessica, Demski Sarah, Faulkner-Jones Beverly, Giurini John

机构信息

Second Year Resident, Beth Israel Deaconess Medical Center, Boston, MA.

Third Year Resident, Beth Israel Deaconess Medical Center, Boston, MA.

出版信息

J Foot Ankle Surg. 2014 Jan-Feb;53(1):79-82. doi: 10.1053/j.jfas.2012.12.020. Epub 2013 Aug 13.

Abstract

Schwannoma is a benign tumor that arises from the peripheral nerve sheath. It presents as a discrete, often tender, and palpable nodule associated with neurogenic pain or paresthesia when compressed or traumatized. The growth rate is usually slow, and these lesions seldom exceed 2 cm in diameter. We report the case of a large schwannoma arising from the posterior tibial nerve located in the posterior medial ankle. The core needle biopsy findings were suggestive of a schwannoma, with spindle cells strongly and uniformly immunostaining for S-100 protein. The mass was marginally excised. The surgical specimen consisted of a grossly encapsulated white-yellow mass with irregular contours, measuring 3.7 × 3.5 × 2.7 cm. The cut surface showed areas of pin-point hemorrhage. The patient did not encounter any motor deficits; however, early results showed some subjective numbness. Few reports have been published of schwannomas arising from the tibial nerve. Marginal excision appears to be the recommended therapy for this tumor, without any evidence of recurrence at 9 months of follow-up.

摘要

施万细胞瘤是一种起源于周围神经鞘的良性肿瘤。它表现为一个离散的、通常有压痛且可触及的结节,在受压或受创伤时伴有神经源性疼痛或感觉异常。生长速度通常较慢,这些病变直径很少超过2厘米。我们报告一例起源于位于内踝后方的胫后神经的巨大施万细胞瘤病例。粗针活检结果提示为施万细胞瘤,梭形细胞对S-100蛋白呈强而均匀的免疫染色。对肿块进行了边缘切除。手术标本为一个大体上有包膜的白黄色肿块,轮廓不规则,大小为3.7×3.5×2.7厘米。切面可见针尖样出血区域。患者未出现任何运动功能障碍;然而,早期结果显示有一些主观麻木感。关于起源于胫神经的施万细胞瘤的报道很少。边缘切除似乎是该肿瘤的推荐治疗方法,随访9个月无复发迹象。

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