Haigh Thomas, Glore John Raad, Gouldesbrough David, Wong Winson
Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK.
Bradford Teaching Hospitals NHS Foundation Trust, University of Leeds, UK.
Case Rep Otolaryngol. 2017;2017:3107362. doi: 10.1155/2017/3107362. Epub 2017 Feb 7.
Schwannomas are benign nerve sheath tumours arising from Schwann cells. They comprise 1% of all benign tumours. In the 2016 World Health Organisation Classification of Central Nervous System, they are classified as a tumour of the cranial and paraspinal nerves, Schwannoma 9560/0. A 23-year-old Caucasian lady presented with a seven-month history of a painless right upper lip lump. Examination revealed a small cystic 0.5 cm diameter lesion within the right upper lip. The clinical impression was that of a mucocele. Excision of the lip lesion was performed under local anaesthetic. Histological examination of the excised lesion demonstrated a circumscribed nodule consisting of spindle cells mixed with vascular spaces containing red blood cells and fibrin. Immunohistochemistry for S100 was strongly positive. The findings were consistent with that of a small benign schwannoma. The current consensus is for surgical excision of a conservative nature with no need for margins. If recurrence does occur one needs to consider whether complete enucleation was achieved or whether malignant transformation has occurred.
施万细胞瘤是起源于施万细胞的良性神经鞘瘤。它们占所有良性肿瘤的1%。在2016年世界卫生组织中枢神经系统分类中，它们被归类为颅神经和椎旁神经肿瘤，施万细胞瘤9560/0。一名23岁的白人女性出现右上唇无痛性肿块7个月。检查发现右上唇有一个直径0.5厘米的小囊性病变。临床诊断为黏液囊肿。在局部麻醉下对唇部病变进行切除。对切除病变的组织学检查显示为一个边界清楚的结节，由梭形细胞与含有红细胞和纤维蛋白的血管间隙混合组成。S100免疫组化呈强阳性。这些发现与小的良性施万细胞瘤一致。目前的共识是进行保守性手术切除，无需切缘。如果确实发生复发，则需要考虑是否实现了完整摘除或是否发生了恶性转化。
