Yamasaki Alisa, Sedaghat Ahmad R, Lin Giant C, Curry William T, Shih Helen A, Gray Stacey T
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States ; Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States.
Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States.
J Neurol Surg Rep. 2015 Jul;76(1):e48-51. doi: 10.1055/s-0034-1544112. Epub 2015 Feb 5.
Background Schwannomas of the vidian canal are an extremely rare type of intracranial tumor that can have variable clinical presentations including headache, facial pain, facial muscle paralysis, decreased lacrimation, or nasal dryness. We present an atypical case of an incidentally identified asymptomatic vidian canal schwannoma. Case Description A 49-year-old woman with a history of multiple sclerosis presented for routine surveillance magnetic resonance imaging that detected an ovoid mass originating in the vidian canal. Given the unusual location of the lesion, an endoscopic endonasal biopsy was performed and confirmed the diagnosis of a vidian canal schwannoma, for which the patient chose to receive fractionated radiation therapy. Conclusion When a vidian canal tumor is identified, endoscopic endonasal biopsy can be used to confirm the diagnosis before pursuing either surgical or radiotherapy treatment. In particular, fractionated radiation therapy offers a radiobiologically safe means of delivering radiation when there is concern for late radiation-related side effects following treatment completion.
背景 翼管神经鞘瘤是一种极为罕见的颅内肿瘤,临床表现多样,包括头痛、面部疼痛、面部肌肉麻痹、泪液分泌减少或鼻腔干燥。我们报告一例偶然发现的无症状翼管神经鞘瘤的非典型病例。病例描述 一名有多发性硬化病史的49岁女性接受常规监测磁共振成像检查时,发现一个起源于翼管的椭圆形肿块。鉴于病变位置特殊,进行了鼻内镜下活检,确诊为翼管神经鞘瘤,患者选择接受分次放射治疗。结论 当发现翼管肿瘤时,在采取手术或放射治疗之前,可通过鼻内镜下活检来确诊。特别是,当担心治疗完成后出现晚期放射性相关副作用时,分次放射治疗提供了一种放射生物学安全的放疗方式。