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罕见病例报告:下咽后区孤立性神经纤维瘤。

A rare case report of an solitary neurofibroma in postcricoid region of hypopharynx.

机构信息

Department of Otolaryngology-Head & Neck Surgery.

Department of Radiology, First Hospital of Jilin University, Changchun, Jilin Province, People's Republic of China.

出版信息

Medicine (Baltimore). 2021 Jan 8;100(1):e24017. doi: 10.1097/MD.0000000000024017.

Abstract

RATIONALE

Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be challenging in both diagnosis and treatment. This case sheds light on the possibility of treatment with transoral microsurgery before pursuing open cervical incisions.

PATIENT CONCERNS

: A 43-year-old man presented with a four months history of a persistent foreign body sensation and mild dysphagia. Indirect and direct laryngoscopy at admission revealed a round and smooth submucosal mass in the postcricoid region.

DIAGNOSIS

A laryngeal enhanced computed tomography and laryngoscopy suggested that the tumor located in hypopharynx, with clear boundary and slightly strengthened edge. A supporting laryngoscopy surgery was performed under general anesthesia and a biopsy confirmed solitary neurofibroma of the postcricoid region.

INTERVENTIONS

The tumor was successfully resected en bloc transorally through supporting laryngoscope, and obviated the need for open cervical surgery and tracheostomy.

OUTCOMES

The patient recovered well without any intraoperative or postoperative complication and was discharged from hospital 2 days after surgery. There was no recurrence after 6 months follow-up.

LESSONS

Postcricoid neurofibroma is an extremely rare hypopharynx tumor that can be diagnostically challenging. To the best of our knowledge, this is the first case reported of solitary neurofibroma originating from the postcricoid region of the hypopharynx and was surgically removed with transoral surgery through supporting laryngoscope.

摘要

背景

环后神经纤维瘤是一种极为罕见的下咽肿瘤,在诊断和治疗方面都极具挑战性。本病例提示,在进行开放性颈侧切开术之前,经口内镜微创手术治疗下咽肿瘤具有一定的可行性。

病例介绍

一名 43 岁男性,因持续四个月的异物感和轻度吞咽困难而就诊。入院时间接喉镜和直接喉镜检查发现环后区有一个圆形光滑的黏膜下肿块。

诊断

喉部增强 CT 和喉镜检查提示肿瘤位于下咽,边界清晰,边缘略强化。全身麻醉下行支撑喉镜下活检术,术后病理证实为环后区孤立性神经纤维瘤。

治疗

经支撑喉镜成功整块切除肿瘤,避免了开放性颈侧手术和气管切开术。

结果

患者术中术后均无并发症,术后 2 天出院,恢复良好。6 个月随访无复发。

结论

环后神经纤维瘤是一种极为罕见的下咽肿瘤,诊断具有挑战性。据我们所知,这是首例报告的起源于下咽环后区的孤立性神经纤维瘤,并通过支撑喉镜下经口内镜微创手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bc2/7793459/cfb1441c9ca7/medi-100-e24017-g001.jpg

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