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[前颅底神经鞘瘤]

[Anterior skull-base schwannoma].

作者信息

Esquivel-Miranda Miguel, De la O Ríos Elier, Vargas-Valenciano Emmanuelle, Moreno-Medina Eva

机构信息

Departamento de Neurocirugía, Hospital México, Costa Rica; Programa de Investigación Neurocirugía y Órganos de los Sentidos (PINECOS), Universidad de Costa Rica, San José, Costa Rica.

Departamento Anestesiología y Recuperación, Hospital Calderón Guardia, Costa Rica; Programa de Investigación Neurocirugía y Órganos de los Sentidos (PINECOS), Universidad de Costa Rica, San José, Costa Rica.

出版信息

Neurocirugia (Astur). 2017 Nov-Dec;28(6):298-305. doi: 10.1016/j.neucir.2017.04.002. Epub 2017 Jun 24.

Abstract

Schwannomas are nerve sheath tumours that originate in Schwann cells. They are usually solitary and sporadic and manifest on peripheral, spinal or cranial nerves. Intracranial schwannomas tend to manifest on the eighth cranial nerve, particularly in patients with neurofibromatosis type2. Anterior skull-base schwannomas represent less than 1% of all intracranial schwannomas. They are more frequent in young people and are typically benign. These tumours represent a diagnostic challenge due to their rarity and difficult differential diagnosis, and numerous theories have been postulated concerning their origin and development. In this article, we present the case of a 13-year-old male with a single anterior cranial-base tumour not associated with neurofibromatosis who presented with headache, papilloedema, eye pain and loss of visual acuity. Complete resection of the tumour was performed, which was histopathologically diagnosed as a schwannoma. The patient made a complete clinical recovery with abatement of all symptoms. We conducted a review of the literature and found 66 cases worldwide with this diagnosis. We describe the most relevant epidemiological and clinical characteristics of this kind of tumour and its relation with the recently discovered and similar olfactory schwannoma.

摘要

施万细胞瘤是起源于施万细胞的神经鞘瘤。它们通常为单发且散发性,可出现在周围神经、脊神经或颅神经上。颅内施万细胞瘤倾向于出现在第八对颅神经上,尤其是在患有2型神经纤维瘤病的患者中。前颅底施万细胞瘤占所有颅内施万细胞瘤的比例不到1%。它们在年轻人中更为常见,通常为良性。由于其罕见性和鉴别诊断困难,这些肿瘤构成了诊断挑战,关于其起源和发展有许多假说。在本文中,我们报告了一例13岁男性患者,其患有单个与神经纤维瘤病无关的前颅底肿瘤,表现为头痛、视乳头水肿、眼痛和视力丧失。肿瘤被完整切除,经组织病理学诊断为施万细胞瘤。患者临床完全康复,所有症状均减轻。我们对文献进行了回顾,在全球范围内发现了66例此类诊断病例。我们描述了这种肿瘤最相关的流行病学和临床特征及其与最近发现的类似嗅神经鞘瘤的关系。

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