[一例酷似直肠癌转移的盆腔神经鞘瘤病例]
[A Case of Pelvic Schwannoma, Mimicking Metastasis of Rectal Carcinoma].
作者信息
Watanabe Yuichiro, Baba Hiroyuki, Matsuzawa Takeaki, Fukuchi Minoru, Kumagai Youichi, Ishibashi Keiichiro, Mochiki Erito, Ishida Hideyuki
机构信息
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
出版信息
Gan To Kagaku Ryoho. 2015 Nov;42(12):2262-4.
INTRODUCTION
Schwannoma in the lateral lymph node region is extremely rare; however, this tumor has been reported to have relatively high SUV on PET-CT, suggestive of malignancy.
CASE
A 67-year-old man with advanced lower rectal cancer had a small nodule with FDG accumulation (SUVmax 2.6) near the left internal iliac artery. His preoperative diagnosis was rectal cancer with lateral lymph node metastasis. He underwent super-low anterior resection with lateral lymph node dissection. Histopathological examination was conclusive for pT3 (A), with an Rt263D lymph node metastasis. Interestingly, a schwannoma was detected among the harvested lymph nodes.
CONCLUSION
Although rectal cancer is known to involve pelvic lymph nodes, the role of preoperative diagnosis with FDG-PET is unclear. We should consider that schwannoma is associated with slight elevation of SUVmax and it may mimic lymph node metastasis.
引言
外侧淋巴结区域的施万细胞瘤极为罕见；然而，据报道该肿瘤在PET-CT上具有相对较高的SUV，提示为恶性。
病例
一名67岁晚期低位直肠癌男性患者，在左髂内动脉附近有一个FDG摄取的小结节（SUVmax 2.6）。其术前诊断为直肠癌伴外侧淋巴结转移。他接受了超低位前切除术及外侧淋巴结清扫术。组织病理学检查确诊为pT3（A），伴有Rt263D淋巴结转移。有趣的是，在切除的淋巴结中发现了一个施万细胞瘤。
结论
尽管已知直肠癌会累及盆腔淋巴结，但FDG-PET术前诊断的作用尚不清楚。我们应考虑到施万细胞瘤与SUVmax轻度升高有关，且可能会误诊为淋巴结转移。
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