Center of Minimally Invasive Treatment for Tumor, Department of Medical Ultrasound, Shanghai Tenth People's Hospital, Shanghai, China.
Ultrasound Research and Education Institute, Clinical Research Center for Interventional Medicine, School of Medicine, Tongji University, Shanghai, China.
Clin Hemorheol Microcirc. 2022;80(4):437-446. doi: 10.3233/CH-211301.
Schwannoma is a benign tumor that originates from Schwann cells in the nerve sheathing of cranial, other peripheral, or autonomic nerves. Patients often present with painless mass as the chief complaint. The main symptoms of this tumor are related to its size and specific nerve origin. At present, the pretreatment diagnosis is mainly made by ultrasound, CT, MR, or biopsy, and the main treatment is surgical resection. We reported a new treatment method for cervical schwannoma in a 65-year-old woman with a history of non-small cell lung cancer (NSCLC). When the patient's neck mass was initially found with hoarseness and severe cough, it was considered as cervical lymph node metastasis of lung cancer due to her medical history. And she was diagnosed with schwannoma by core-needle biopsy after chemotherapy failed and the tumor shrank after the radiotherapy with no improvement of the clinical symptoms. After considering the physical condition, the patients were treated in our department for minimal invasiveness treatment. The patient was definitively diagnosed with cervical vagus schwannoma and was treated with ultrasound-guided microwave ablation of schwannoma under general anesthesia with systematic evaluation and improved preoperative examination. Her condition was stable, and the symptoms of severe cough disappeared after anesthesia resuscitation and the ablation. The tumor continued to shrink after the operation with no recurrence of cough symptoms. Ultrasound-guided percutaneous microwave ablation (MWA) for cervical vagus schwannomas might be a minimally invasive, effective, and relatively safe alternative to conventional treatment for those patients with severe symptoms.
神经鞘瘤是一种起源于颅神经、其他周围神经或自主神经鞘的施万细胞的良性肿瘤。患者常以无痛性肿块为主要主诉。该肿瘤的主要症状与其大小和特定的神经起源有关。目前，术前诊断主要通过超声、CT、MR 或活检进行，主要治疗方法是手术切除。我们报告了一例 65 岁女性的颈神经鞘瘤的新治疗方法，该患者有非小细胞肺癌（NSCLC）病史。当患者最初发现颈部肿块时伴有声音嘶哑和剧烈咳嗽，由于她的病史，考虑为肺癌的颈部淋巴结转移。化疗后肿块缩小，而症状无改善，经粗针活检诊断为神经鞘瘤。考虑到患者的身体状况，我们在我科对其进行了微创治疗。该患者最终被诊断为颈迷走神经鞘瘤，并在全麻下进行了超声引导下的神经鞘瘤微波消融治疗，同时进行了系统评估和改进的术前检查。患者麻醉复苏和消融后病情稳定，剧烈咳嗽症状消失。术后肿瘤继续缩小，无咳嗽症状复发。超声引导下经皮微波消融（MWA）治疗颈迷走神经鞘瘤可能是一种微创、有效、相对安全的替代传统治疗方法，适用于症状严重的患者。
