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上肢神经鞘瘤的手术治疗结果。

Outcomes of surgery for schwannomas of the upper extremity.

作者信息

Żyluk Andrzej, Owczarska Ada

机构信息

Department of General and Hand Surgery, Pomeranian Medical University in Szczecin, Poland.

出版信息

Pol Przegl Chir. 2021 Dec 8;94(2):49-53. doi: 10.5604/01.3001.0015.5919.

DOI:10.5604/01.3001.0015.5919
PMID:35485319
Abstract

<b>Introduction:</b> Schwannoma is a nerve tumor originating from Schwann-cells of the nerve sheath. It is found in all body regions, the most frequent in the head, neck and in the extremities. </br></br> <b>Aim:</b> The objective of this study was analysis of outcomes of surgery for these lesions in the authors' institution. </br></br> <b>Materials and methods:</b> Results of the treatment of 12 patients, 7 women and 5 men, aged a mean of 40 years with shwannomas localized in the upper limb are presented. The follow-up assessment was performed in a form of telephone interview at a mean of 4.2 years post-operatively. </br></br> <b>Results:</b> The tumors were located in the hand in 5 patients, in the forearm in other 5 and in the wrist in 2. In 3 patients the tumors originated form the median, in 2 from the ulnar and in 2 from the radial nerves; in 5 cases it grew from small nerve branches. All lesions of the median, ulnar and radial nerves were encapsulated without damage of the nerve fascicles, while in the hand they were resected in total. At a mean of 4.2 years of follow-up, two recurrences (17%) occurred, both following resection of the tumor located in the hand. Complications were noted in 5 patients: two felt parasthesiae in the operated finger, two were disappointed due to unaesthetic scar and one patient following tumor resection from posterior interosseous nerve had incomplete finger extension. </br></br> <b>Conclusion:</b> Outcomes of surgery for these rare tumors are generally good, but functional deficits should be considered in cases of lesions involving motoric nerves.

摘要

引言:施万细胞瘤是一种起源于神经鞘雪旺细胞的神经肿瘤。它可发生于身体各个部位,最常见于头、颈和四肢。

目的:本研究的目的是分析作者所在机构对这些病变进行手术的结果。

材料与方法:报告了12例上肢施万细胞瘤患者的治疗结果,其中女性7例,男性5例,平均年龄40岁。术后平均4.2年以电话访谈的形式进行随访评估。

结果:5例患者肿瘤位于手部,5例位于前臂,2例位于腕部。3例肿瘤起源于正中神经,2例起源于尺神经,2例起源于桡神经;5例由小神经分支长出。所有正中神经、尺神经和桡神经的病变均有包膜包裹,神经束未受损伤,而手部的病变均被完整切除。随访平均4.2年时,出现2例复发(17%),均为手部肿瘤切除术后。5例患者出现并发症:2例患者手术手指有感觉异常,2例因瘢痕不美观而不满意,1例患者在骨间后神经肿瘤切除术后手指伸展不完全。

结论:这些罕见肿瘤的手术效果总体良好,但对于累及运动神经的病变,应考虑功能缺损问题。

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引用本文的文献

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Surgery of Schwannoma in the upper limb - sensitivity and specificity of preoperative magnetic resonance imaging and relation between tumour size and symptoms.上肢神经鞘瘤的手术治疗——术前磁共振成像的灵敏度和特异性,以及肿瘤大小与症状之间的关系。
BMC Musculoskelet Disord. 2023 Sep 7;24(1):713. doi: 10.1186/s12891-023-06838-4.
2
Diagnosing Schwannoma in the Wrist: a Challenging Case of Intraneural Ganglion Cyst Mimicry and a Review of Literature.诊断腕部神经鞘瘤:一例具有挑战性的神经内腱鞘囊肿误诊病例及文献综述
Case Reports Plast Surg Hand Surg. 2023 Aug 26;10(1):2249099. doi: 10.1080/23320885.2023.2249099. eCollection 2023.
3
Case Report: Upper limb dysfunction may be caused by chest wall mass excision: An enlightenment from a special case.
病例报告:胸壁肿物切除可能导致上肢功能障碍——来自一例特殊病例的启示
Front Oncol. 2022 Aug 3;12:947055. doi: 10.3389/fonc.2022.947055. eCollection 2022.