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腓肠神经孤立性神经鞘瘤:一种不寻常的临床表现。

Solitary schwannoma of the sural nerve: An unusual clinical presentation.

作者信息

Yamamoto Kosuke, Nishio Jun, Yano Shintaro, Naito Masatoshi

机构信息

Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan.

出版信息

Exp Ther Med. 2014 Jan;7(1):90-92. doi: 10.3892/etm.2013.1395. Epub 2013 Nov 8.

Abstract

Schwannomas may arise from any peripheral nerve containing Schwann cells. However, sural nerve schwannoma is extremely rare. In this study, a case of solitary schwannoma originating from the sural nerve in a 42-year-old male is presented. Physical examination revealed a 3-cm, elastic-hard, mobile, non-tender mass, while neurovascular examinations, including Tinel's sign, were normal. Magnetic resonance imaging revealed an oval-shaped subcutaneous mass with iso-signal intensity relative to skeletal muscle on T1-weighted sequences. T2-weighted spectral presaturation with inversion recovery sequences showed higher signal intensity peripherally and lower signal intensity centrally, representing a target sign. Contrast-enhanced T1-weighted sequences demonstrated a marked central enhancement of the mass. The tumor was completely enucleated using an intracapsular technique. Histological examination confirmed the diagnosis of a schwannoma, consisting mainly of Antoni A tissue. The patient had no evidence of local recurrence and no neurological deficit at the final follow-up. Although rare, schwannoma should be considered in the differential diagnosis of a well-defined, oval, subcutaneous mass in the posterior aspect of the lower leg.

摘要

施万细胞瘤可起源于任何含有施万细胞的周围神经。然而,腓肠神经施万细胞瘤极为罕见。在本研究中,报告了一例42岁男性起源于腓肠神经的孤立性施万细胞瘤。体格检查发现一个3厘米大小、质地硬且有弹性、可活动、无压痛的肿块,而包括Tinel征在内的神经血管检查均正常。磁共振成像显示在T1加权序列上,相对于骨骼肌呈等信号强度的椭圆形皮下肿块。T2加权频谱预饱和反转恢复序列显示肿块周边信号强度较高,中央信号强度较低,呈现靶征。对比增强T1加权序列显示肿块中央明显强化。采用囊内技术将肿瘤完整摘除。组织学检查确诊为施万细胞瘤,主要由Antoni A组织构成。在最后一次随访时,患者无局部复发迹象,也无神经功能缺损。尽管罕见,但在鉴别诊断小腿后侧边界清晰的椭圆形皮下肿块时,应考虑施万细胞瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f54d/3861236/fa42a433f078/ETM-07-01-0090-g00.jpg

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