Choi June Seok, Park Sang Min, Choi Kyung-Un
Department of Plastic and Reconstructive Surgery, Pusan National University Hospital, Busan, Korea.
Department of Pathology, Pusan National University Hospital, Busan, Korea.
Arch Craniofac Surg. 2018 Sep;19(3):231-234. doi: 10.7181/acfs.2018.02033. Epub 2018 Sep 20.
A schwannoma is a benign tumor that develops from Schwann cells. It is known to occur more frequently in women than men, and about one third of schwannoma cases occur in the head and neck area. It is also known to originate mainly in the auditory nerve. However, it is rarely associated with the trigeminal nerve, and especially, schwannomas related to the infraorbital nerve are very rare. we report a rare case of a schwannoma involving the infraorbital branch of the trigeminal nerve in a 45-year old male adult. The patient underwent physical examination and magnetic resonance imaging. The mass was approached through subciliary approach that is familiar to the plastic surgeon and completely resected. Histopathological findings showed pointed to a benign schwannoma. Infraorbital nerve schwannoma is difficult to distinguish from other diseases by means of clinical symptoms, physical findings, or imaging. In spite of its rarity, infraorbital nerve schwannoma may be considered a possible diagnosis in the case of mass on cheek. Assessment by computed tomography or magnetic resonance imaging is necessary for proper diagnosis. About the surgical approach, excision through the subciliary approach should be considered rather than the direct transfacial approach in view of stability, cosmetic effects, and familiarity.
施万细胞瘤是一种由施万细胞发展而来的良性肿瘤。已知其在女性中比男性更常见,约三分之一的施万细胞瘤病例发生在头颈部区域。还已知其主要起源于听神经。然而,它很少与三叉神经相关,尤其是与眶下神经相关的施万细胞瘤非常罕见。我们报告一例45岁成年男性涉及三叉神经眶下支的施万细胞瘤罕见病例。患者接受了体格检查和磁共振成像。通过整形外科医生熟悉的睑缘下入路接近肿块并完全切除。组织病理学检查结果显示为良性施万细胞瘤。眶下神经施万细胞瘤难以通过临床症状、体格检查或影像学与其他疾病区分开来。尽管罕见,但在脸颊出现肿块的情况下,眶下神经施万细胞瘤可被视为一种可能的诊断。为了正确诊断,需要进行计算机断层扫描或磁共振成像评估。关于手术入路,鉴于稳定性、美容效果和熟悉程度,应考虑通过睑缘下入路切除,而不是直接经面部入路。