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腭部小肿块:口腔内施万细胞瘤的一种罕见表现。

Small palatal swelling: an uncommon presentation of intraoral schwannoma.

作者信息

Gueiros Luiz Alcino, Barkokebas Andreza, Carvalho Alessandra Tavares, Leão Jair Carneiro

出版信息

Gen Dent. 2017 May-Jun;65(3):58-61.

Abstract

Schwannomas are uncommon benign tumors arising in the nerve-supporting Schwann cells. Intraoral lesions usually present in the tongue or floor of the mouth as a submucosal nodule, while the palate is rarely affected. A 26-year-old white man presented with an asymptomatic submucosal fibroelastic nodule in the hard palate. The 2 × 2-cm lesion was covered by normal-appearing mucosa. Under the working diagnosis of minor salivary gland tumor, an incisional biopsy was performed, and analysis revealed an encapsulated tumor with a well-defined biphasic pattern: hypercellular areas with spindled cells arranged in palisades and less cellular areas formed by irregular arranged masses of elongated cells and fibers. The diagnosis of schwannoma was rendered, and the lesion was excised together with periosteum. No recurrence was observed after 30 months of follow-up. Palatal nodules usually present as minor salivary gland tumors; rarer lesions, such as schwannomas, represent a clinical diagnostic challenge. Clinicians should consider schwannoma in the differential diagnosis for palatal nodules and manage them with incisional biopsy and prompt treatment.

摘要

施万细胞瘤是起源于神经支持性施万细胞的罕见良性肿瘤。口腔内病变通常表现为舌部或口腔底部的黏膜下结节,而腭部很少受累。一名26岁白人男性患者硬腭出现一个无症状的黏膜下纤维弹性结节。这个2×2厘米的病变被外观正常的黏膜覆盖。在初步诊断为小唾液腺肿瘤的情况下,进行了切开活检,分析显示为一个有包膜的肿瘤,具有明确的双相模式:细胞丰富区域有呈栅栏状排列的梭形细胞,细胞较少区域由不规则排列的细长细胞和纤维团块组成。诊断为施万细胞瘤,病变连同骨膜一起切除。随访30个月后未观察到复发。腭部结节通常表现为小唾液腺肿瘤;较罕见的病变,如施万细胞瘤,是临床诊断的挑战。临床医生在腭部结节的鉴别诊断中应考虑施万细胞瘤,并通过切开活检和及时治疗进行处理。

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