Department of Orthopaedics and Trauma, Hospital Professor Doutor Fernando Fonseca E.P.E., IC 19, 2720-276 Amadora, Portugal.
Hospital da Força Aérea Portuguesa, Portugal.
Foot Ankle Surg. 2014 Jun;20(2):e23-6. doi: 10.1016/j.fas.2014.01.003. Epub 2014 Jan 30.
A rare case of a large foot schwannoma with an intraosseous component is presented. Due to suspicion of malignancy, an amputation had previously been proposed. When the patient presented to us, the prolonged clinical course as well as some elements of the imaging exams suggested benignancy and we decided for complete tumor excision. Intraoperative findings supported the benign character of the neoplasm and pathology would later confirm the diagnosis of a benign schwannoma. The outcome, at 18 months of follow-up was a fully functional limb. Recurrence must still be considered but malignant transformation is very rare in a solitary schwannoma and can be discounted. Solitary benign schwannomas have a negligible malignization potential independently of their size or osseous component. When benignancy is considered, primary total tumor excision, as part of a staged procedure, is a safe approach. It allows for a thorough pathologic examination and eventually for a definitive treatment.
本文报告了一例罕见的足部巨大许旺细胞瘤伴骨内成分。由于怀疑恶性肿瘤，先前曾提出截肢。当患者就诊时，其较长的临床病程以及影像学检查的一些特征提示良性病变，我们决定进行肿瘤完全切除。术中所见支持该肿瘤的良性特征，随后的病理检查也证实了良性许旺细胞瘤的诊断。18 个月的随访结果显示，肢体功能完全恢复。虽然仍需考虑复发的可能性，但孤立性许旺细胞瘤的恶性转化非常罕见，可以排除。孤立性良性许旺细胞瘤的恶变潜能极小，与其大小或骨内成分无关。如果考虑为良性病变，作为分期手术的一部分，进行原发性肿瘤完全切除是一种安全的方法。它可以进行彻底的病理检查，并最终进行确定性治疗。
