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一名10岁女孩的原发性气管神经鞘瘤:病例报告。

Primary intratracheal neurilemmoma in a 10-year-old girl: A case report.

作者信息

Wu Lei, Sha Mi-Cun, Wu Xi-Ling, Bi Jing, Chen Zhi-Min, Wang Ying-Shuo

机构信息

Department of Pulmonology and Endoscopy Center, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310003, Zhejiang Province, China.

Department of Pediatrics, Suqian People's Hospital of Nanjing Drum-Tower Hospital Group, Suqian 223800, Jiangsu Province, China.

出版信息

World J Clin Cases. 2021 Oct 16;9(29):8888-8893. doi: 10.12998/wjcc.v9.i29.8888.

Abstract

BACKGROUND

Tracheal tumors are relatively rare in adults and uncommon in children. Tracheal neurilemmoma is a rare condition in adults that usually affects middle-aged people, but it can also occur in children. Because the clinical presentation is nonspecific and insidious, diagnosis is often delayed. The most common symptoms in these patients are stridor or wheezing (especially positional) and cough. A few patients are misdiagnosed and mistakenly treated for asthma.

CASE SUMMARY

A 10-year-old girl was admitted to our unit with a 2-mo history of recurrent cough, dyspnea, and tachypnea. Her condition was more severe after exercise. Her symptoms progressed despite treatment with inhaled fluticasone/salmeterol. Flexible electronic laryngoscopy showed a red, smooth, and round mushroom-shaped mass in the trachea, about 1 cm below the vocal cords. The surface of the mass was covered with several small and discontinuous blood vessels. About 90% of the tracheal lumen was occupied by the mass. A multidisciplinary operation was performed. The surgically resected mass was diagnosed as benign neurilemmoma by immunohistochemical analysis.

CONCLUSION

Intratracheal neurilemmoma is fairly rare in children. The main symptoms include coughing, wheezing, and dyspnea. The tumor's size, location, and degree of intratracheal and extratracheal invasion can be measured by chest computed tomography. The main treatment strategies used for tracheal neurilemmoma are surgical resection and endoscopic excision. Long-term follow-up is warranted for the evaluation of outcomes and complications.

摘要

背景

气管肿瘤在成人中相对罕见,在儿童中则更为少见。气管神经鞘瘤在成人中是一种罕见疾病,通常影响中年人,但也可发生于儿童。由于临床表现不具特异性且隐匿,诊断往往延迟。这些患者最常见的症状是喘鸣或喘息(尤其是体位性)以及咳嗽。少数患者被误诊并误作为哮喘进行治疗。

病例摘要

一名10岁女孩因反复咳嗽、呼吸困难和气促2个月入住我科。运动后她的病情加重。尽管使用吸入性氟替卡松/沙美特罗治疗,她的症状仍进展。可弯曲电子喉镜检查显示在气管内,声带下方约1 cm处有一个红色、光滑且呈圆形蘑菇状肿物。肿物表面覆盖有几条细小且不连续的血管。约90%的气管腔被肿物占据。进行了多学科手术。手术切除的肿物经免疫组织化学分析诊断为良性神经鞘瘤。

结论

气管内神经鞘瘤在儿童中相当罕见。主要症状包括咳嗽、喘息和呼吸困难。胸部计算机断层扫描可测量肿瘤的大小、位置以及气管内和气管外的侵犯程度。气管神经鞘瘤的主要治疗策略是手术切除和内镜切除。需要进行长期随访以评估疗效和并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a3e0/8546825/a206cf254223/WJCC-9-8888-g001.jpg

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