Gerhardt Caroline A, Belzarena Ana C, Henderson-Jackson Evita, Mullinax John E, Joyce David M
Sarcoma Department, Moffitt Cancer Center, Tampa, FL.
Orthopaedic Oncology Department, Miami Cancer Institute, 8900 N Kendall Dr., Miami, FL 33176.
Radiol Case Rep. 2020 Sep 22;15(11):2385-2390. doi: 10.1016/j.radcr.2020.09.021. eCollection 2020 Nov.
Melanocytic schwannoma is a rare nerve tumor characterized by melanin-producing neoplastic Schwann cells. Wide surgical resection is the management of choice for this tumor; however, anatomical location and proximity to nerve roots can make locating this tumor and the surgical resection challenging. Here we describe the case of 49-year-old male with a melanocytic schwannoma in the presacral area adjacent to the second sacral nerve root that was managed by wide resection aided by computer-assisted navigation due to the difficulty in identifying its location intraoperatively. The utilization of computer-assisted navigation improves accuracy and precision through the creation of a virtual continuous tridimensional map, particularly useful when oftentimes tumor margins may seem equivocal and further resection would compromise the patient's functionality. The value of computer-assisted navigation for soft tissue tumor resections in orthopedic oncology is still in its infancy, though, in certain scenarios it may advance the technique for some soft tissue resections.
黑素细胞性神经鞘瘤是一种罕见的神经肿瘤，其特征为产生黑色素的肿瘤性施万细胞。广泛手术切除是该肿瘤的首选治疗方法；然而，肿瘤的解剖位置以及与神经根的接近程度会使定位该肿瘤和进行手术切除具有挑战性。在此，我们描述了一名49岁男性的病例，其在骶前区域紧邻第二骶神经根处患有黑素细胞性神经鞘瘤，由于术中难以确定其位置，在计算机辅助导航的帮助下进行了广泛切除。计算机辅助导航通过创建虚拟连续三维地图提高了准确性和精确性，在肿瘤边界常常不明确且进一步切除会损害患者功能的情况下尤其有用。不过，计算机辅助导航在骨肿瘤学软组织肿瘤切除中的价值仍处于起步阶段，尽管在某些情况下它可能会推动一些软组织切除技术的发展。
