Miyagi T, Shimamura M, Rin S Y, Matsubara F
Hinyokika Kiyo. 1986 Feb;32(2):207-14.
Two cases of retroperitoneal schwannoma, one malignant, and the other benign, are herein reported. The first case was a 71-year-old female with a complaint of dull right flank pain. CT scan showed a large mass, which occupied almost the whole right half of the abdominal cavity extraperitoneally, accompanied by a low density portion in its central part. Angiography showed several feeding arteries, such as intercostal arteries, lumber arteries, and so on. Many tortuous and thin irregular vessels were seen. Tumor excision was performed under the diagnosis of malignant retroperitoneal tumor. No surrounding invasion or metastasis were seen. The tumor had a thick capsule, and cut surface showed lobulated appearance. No adjuvant therapy was done. Histological diagnosis was low grade malignant schwannoma. She is alive and well 17 months postoperatively. The second case was a 64 year-old male. His tumor was found incidentally, when he underwent a close examination of his gastric ulcer. According to CT scan, it was located behind the left kidney, and had a diameter of 3.0 X 2.5 cm. The tumor was removed including the fascia of lateral edge of quadratus lumbolum muscle, where it was firmly attached to. Surgical specimen showed a doughnut like appearance, because of its marked central necrosis. It had a white and thick capsule. Histological diagnosis was benign schwannoma of two different types, Antoni A and B. He remains well 13 months after operation. The 113 benign cases and 55 malignant cases reported in Japan, including our cases, were reviewed and discussed.
本文报告了两例腹膜后神经鞘瘤,一例为恶性,另一例为良性。第一例是一名71岁女性,主诉右下腹隐痛。CT扫描显示一个巨大肿块,几乎占据了腹腔右半部分的整个腹膜外区域,中央部分有低密度区。血管造影显示有几条供血动脉,如肋间动脉、腰动脉等。可见许多迂曲细小的不规则血管。在诊断为恶性腹膜后肿瘤的情况下进行了肿瘤切除。未见周围侵犯或转移。肿瘤有一层厚包膜,切面呈分叶状。未进行辅助治疗。组织学诊断为低度恶性神经鞘瘤。术后17个月她仍健在且状况良好。第二例是一名64岁男性。他在对胃溃疡进行仔细检查时偶然发现了肿瘤。根据CT扫描,肿瘤位于左肾后方,直径为3.0×2.5厘米。肿瘤连同其紧密附着的腰方肌外侧缘筋膜一并切除。手术标本呈甜甜圈样外观,因为有明显的中央坏死。它有一层白色厚包膜。组织学诊断为两种不同类型的良性神经鞘瘤,Antoni A型和B型。术后13个月他状况良好。对包括我们的病例在内的日本报道的113例良性病例和55例恶性病例进行了回顾和讨论。