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成功治疗一例酷似恶性骨肿瘤的罕见桡骨神经鞘瘤:病例报告及文献复习

Successful management of a rare radius schwannoma mimicking malignant bone tumors: A case report and literature review.

作者信息

Sun Nianzhe, Khan Umar Zeb, Zeng Lei, Wu Panfeng, Xiong Qin, Peng Lushan, Yu Hong, Tang Juyu

机构信息

Department of Orthopedics, Hand & Microsurgery, National Clinical Research Center of Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China.

Department of Pathology, Xiangya Hospital of Central South University, Changsha, China.

出版信息

Front Surg. 2023 Feb 23;10:1108942. doi: 10.3389/fsurg.2023.1108942. eCollection 2023.

Abstract

BACKGROUND

Schwannomas are benign tumors originating from Schwann cells, frequently occurring in the spinal cord and peripheral nerves. Intraosseous schwannomas, a rare subset, account for approximately 0.2% of schwannomas. Intraosseous schwannomas commonly impinge the mandible, followed by the sacrum and the spine. By far, only three cases of radius intraosseous schwannomas have been reported in PubMed. The tumor was treated differently in all three cases, resulting in different outcomes.

CASE PRESENTATION

A 29-year-old male construction engineer who complained of a painless mass on the radial aspect of the right forearm was diagnosed with an intraosseous schwannoma of the radius based on radiography, three-dimensional computed tomography reconstruction, magnetic resonance imaging, pathological examination, and immunohistochemistry. A different surgical approach was employed to reconstruct the radial graft defect using bone microrepair techniques, resulting in more reliable bone healing and early functional recovery. Meanwhile, no clinical and radiographic findings suggestive of recurrence were observed at the 12-month follow-up.

CONCLUSION

Vascularized bone flap transplantation combined with three-dimensional imaging reconstruction planning might yield better results for repairing small segmental bone defects of the radius caused by intraosseous schwannomas.

摘要

背景

施万细胞瘤是起源于施万细胞的良性肿瘤,常见于脊髓和周围神经。骨内施万细胞瘤是一种罕见的亚型,约占施万细胞瘤的0.2%。骨内施万细胞瘤通常侵犯下颌骨,其次是骶骨和脊柱。截至目前,在PubMed上仅报道了3例桡骨骨内施万细胞瘤。这3例病例的治疗方式各不相同,导致了不同的结果。

病例介绍

一名29岁的男性建筑工程师,主诉右前臂桡侧有一无痛性肿块,经X线摄影、三维计算机断层扫描重建、磁共振成像、病理检查及免疫组织化学检查,诊断为桡骨骨内施万细胞瘤。采用不同的手术方法,运用骨微修复技术重建桡骨移植缺损,实现了更可靠的骨愈合和早期功能恢复。同时,在12个月的随访中未观察到提示复发的临床和影像学表现。

结论

带血管蒂骨瓣移植联合三维成像重建规划可能为修复骨内施万细胞瘤所致桡骨小节段骨缺损带来更好的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/58fd/9996063/11a4f5346567/fsurg-10-1108942-g001.jpg

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