Takahashi Hiroki, Hara Masayasu, Tsuboi Ken, Sagawa Hiroyuki, Ishiguro Hideyuki, Matsuo Yoichi, Takeyama Hiromitsu
Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Asian J Endosc Surg. 2016 Nov;9(4):307-310. doi: 10.1111/ases.12291. Epub 2016 May 24.
Obturator nerve schwannomas are very rare. To date, only nine cases have been reported in the English-language literature; none of these were diagnosed preoperatively. A 68-year-old woman was admitted with left lower abdominal pain. CT and MRI revealed a mass 30 mm in diameter in the left obturator fossa, suggesting a retroperitoneal tumor. Because CT and MRI revealed clear continuity with the left obturator nerve, this case was diagnosed as an obturator nerve schwannoma. Tumor enucleation was performed by laparoscopy. On histopathological examination, this case was diagnosed as a benign obturator nerve schwannoma. Postoperatively, the patient developed weakness of the adductor muscle but recovered within 6 months with rehabilitation therapy. Preoperative diagnosis of obturator nerve schwannomas is quite difficult, but careful inspection of CT and MRI is important to identify the original nerve of schwannoma preoperatively. Accordingly, laparoscopic resection is a good treatment option.
闭孔神经鞘瘤非常罕见。迄今为止,英文文献中仅报道了9例;这些病例均未在术前得到诊断。一名68岁女性因左下腹疼痛入院。CT和MRI显示左闭孔窝有一个直径30毫米的肿块,提示为腹膜后肿瘤。由于CT和MRI显示与左闭孔神经有明显连续性,该病例被诊断为闭孔神经鞘瘤。通过腹腔镜进行了肿瘤摘除术。组织病理学检查显示,该病例被诊断为良性闭孔神经鞘瘤。术后,患者出现内收肌无力,但经康复治疗后在6个月内恢复。闭孔神经鞘瘤的术前诊断相当困难,但仔细检查CT和MRI对于术前识别神经鞘瘤的原发神经很重要。因此,腹腔镜切除术是一种很好的治疗选择。