Jia Xiaotian, Chen Chao, Chen Lin, Yu Cong, Kondo Tadashi
Department of Hand Surgery, Huashan Hospital, Fudan University Key Laboratory of Hand Reconstruction, Ministry of Health Shanghai Key Laboratory of Peripheral Nerve and Microsurgery Department of Gynecology and Obstetrics, Putuo District Center Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China Division of Rare Cancer Research, National Cancer Center Research Institute, Tokyo, Japan.
Medicine (Baltimore). 2017 Nov;96(44):e8531. doi: 10.1097/MD.0000000000008531.
Malignant granular cell tumor is a kind of rare and highly aggressive malignant tumor that commonly occurs in lower extremity, trunk, and peritoneal cavity. Huge malignant granular cell tumor (MGCT) with suprascapular nerve and brachial plexus invasion was extremely rare.
We present a special case of a 48-year-old orthopedist who suffered from MGCT. The orthopedist had regarded that he suffered from scapulohumeral periarthritis.
The disease was noticed until a painless mass on his right neck was discovered 9 months later. MRI result confirmed a large occupying in axillary fossa, supraclavicular and infraclavicular region.
During the operation, a tumor measuring 22 × 13 × 6 cm with suprascapular nerve and brachial plexus invasion was identified. The tumor was fractional resected carefully to maintain the integrity of nerves and vessels. Lymph nodes were simultaneously resected.
The motor function and sensation of the upper extremity were same to that of preoperation. The postoperative histological diagnosis was MGCT. At a 12-month follow-up, there was no recurrence of the tumor showed by MRI.
This study presents a rare case of large MGCT with suprascapular nerve and brachial plexus invasion that was successfully managed by surgery.
恶性颗粒细胞瘤是一种罕见且侵袭性很强的恶性肿瘤，常见于下肢、躯干和腹腔。伴有肩胛上神经和臂丛神经侵犯的巨大恶性颗粒细胞瘤（MGCT）极为罕见。
我们报告了一例48岁骨科医生患MGCT的特殊病例。该骨科医生曾认为自己患的是肩胛肱骨周围炎。
9个月后发现右颈部无痛性肿块才注意到该病。MRI结果证实腋窝、锁骨上和锁骨下区域有巨大占位。
手术中发现一个大小为22×13×6 cm的肿瘤，伴有肩胛上神经和臂丛神经侵犯。小心地分块切除肿瘤以保持神经和血管的完整性。同时切除淋巴结。
上肢运动功能和感觉与术前相同。术后组织学诊断为MGCT。在12个月的随访中，MRI显示肿瘤无复发。
本研究报告了一例罕见的伴有肩胛上神经和臂丛神经侵犯的巨大MGCT病例，通过手术成功治疗。
