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喉神经鞘瘤,气道紧急肿块:病例报告。

Laryngeal Schwannoma, Alarming Mass of Airway: A Case Report.

机构信息

Department of Otorhinolaryngology & Head and Neck Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal.

Department of Otorhinolaryngology & Head and Neck Surgery, Kathmandu Medical College Teaching Hospital, Kathmandu, Nepal.

出版信息

JNMA J Nepal Med Assoc. 2021 Nov 15;59(243):1185-1188. doi: 10.31729/jnma.6345.

Abstract

Laryngeal schwannomas are rare tumors of neural sheath origin. They normally present as a slow-growing, encapsulated, submucosal mass commonly in the supraglottic region. We describe a 13-year-old boy presenting with a 4-month history of progressive worsening dysphagia. Fiber optic laryngoscopy and computed tomography revealed a polypoidal mass in the laryngeal surface of epiglottis abutting left the aryepiglottic fold, base of the tongue and hypopharyngeal wall. Direct laryngoscopic evaluation and microdebrider assisted debulking was performed with tracheostomy. Schwannoma was confirmed by histopathological study. In a regular follow-up after two months, 70 degree endoscopic evaluation revealed similar mass in the left aryepiglottic fold obscuring the vocal cord. Definite complete excision of the tumor was planned and endoscopic excision of the mass was performed with removal of ipsilateral aryepiglottic fold, arytenoid and false vocal cord with retracheotomy. Rapid occurrence of mass after debulking and biopsy was demonstrated in this case. Though rare, neurogenic tumors of the larynx are life-threatening and need complete removal.

摘要

喉神经鞘瘤是一种罕见的神经鞘起源的肿瘤。它们通常表现为生长缓慢、包膜完整的黏膜下肿块,常见于声门上区。我们描述了一个 13 岁男孩,他因进行性加重的吞咽困难而出现 4 个月的病史。纤维喉镜和计算机断层扫描显示会厌喉面有一个息肉样肿块,累及左侧杓会厌皱襞、舌根和咽后壁。行直接喉镜检查和微型动力切削器辅助部分切除术,并进行气管切开术。通过组织病理学研究证实为神经鞘瘤。两个月后的定期随访中,70 度内镜评估显示左侧杓会厌皱襞有类似肿块,遮挡声带。计划对肿瘤进行明确的完全切除,通过内镜切除肿块,并切除同侧杓会厌皱襞、杓状软骨和假声带,再次进行气管造口术。在这种情况下,肿块在部分切除和活检后迅速生长。尽管罕见,但喉部神经源性肿瘤是危及生命的,需要完全切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09de/9124326/b99532e7890f/JNMA-59-243-1185-g1.jpg

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