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骨内神经鞘瘤的发生与骨内营养血管位置的关系:一例报告

Association between intraosseous schwannoma occurrence and the position of the intraosseous nutrient vessel: A case report.

作者信息

Suzuki Kayo, Yasuda Taketoshi, Watanabe Kenta, Kanamori Masahiko, Kimura Tomoatsu

机构信息

Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.

Department of Human Science 1, Faculty of Medicine, University of Toyama, Toyama 930-0194, Japan.

出版信息

Oncol Lett. 2016 May;11(5):3185-3188. doi: 10.3892/ol.2016.4363. Epub 2016 Mar 22.

Abstract

Intraosseous schwannoma is a rare benign bone tumor that originates from Schwann cells of the nerve sheath. The majority of intraosseous schwannomas arise in the mandible and sacrum, but an intraosseous schwannoma involving the ulna is described in the present case report. Radiologically, the current case presented as a well-defined lytic lesion, with a pathological fracture and no intralesional calcification, in the proximal metaphysis of the left ulna. Using magnetic resonance imaging, an intraosseous mass spreading out from the cortical defect was observed. The lesion appeared isointense to skeletal muscle on T1-weighted images, and hyperintense or heterogeneous on T2-weighted images. The differential diagnosis comprised benign bone tumors, including bone cyst, aneurysmal bone cyst, giant cell tumor and fibrous dysplasia. Based on the results of a needle biopsy, a schwannoma involving the ulnar bone was diagnosed, and tumor marginal resection followed by artificial bone grafting and fixation was performed. A total of one year subsequent to surgery, the patient exhibits no symptoms, and there is no evidence of disease recurrence.

摘要

骨内神经鞘瘤是一种罕见的良性骨肿瘤,起源于神经鞘的施万细胞。大多数骨内神经鞘瘤发生在下颌骨和骶骨,但本病例报告描述了一例累及尺骨的骨内神经鞘瘤。在放射学上,本例表现为左尺骨近端干骺端边界清晰的溶骨性病变,伴有病理性骨折且病灶内无钙化。使用磁共振成像观察到一个从皮质缺损处延伸出来的骨内肿块。该病变在T1加权图像上与骨骼肌信号强度相等,在T2加权图像上呈高信号或不均匀信号。鉴别诊断包括良性骨肿瘤,如骨囊肿、动脉瘤样骨囊肿、骨巨细胞瘤和骨纤维异常增殖症。根据针吸活检结果,诊断为累及尺骨的神经鞘瘤,并进行了肿瘤边缘切除,随后进行人工骨移植和固定。术后一年,患者无症状,无疾病复发迹象。

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