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颈动脉鞘内复发性散发性恶性蝾螈瘤,无神经纤维瘤病。

Recurrent sporadic malignant triton tumor in the carotid sheath in the absence of neurofibromatosis.

机构信息

Division of Neuroradiology, Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.

出版信息

Neuroradiol J. 2024 Jun;37(3):376-380. doi: 10.1177/19714009231196476. Epub 2023 Aug 22.

Abstract

Malignant Triton Tumors (MTTs) are a rare and aggressive subtype of malignant peripheral nerve sheath tumors (MPNSTs), often associated with neurofibromatosis type 1. This case report describes a unique instance of recurrent sporadic MTT within the carotid sheath in a 33-year-old male without any personal or familial history of neurofibromatosis. The patient initially presented with a biopsy-confirmed MTT in the right neck, involving the carotid body and brachial plexus, and underwent partial resection, radiation therapy, and chemotherapy. Six months later, the patient presented with recurrent MTT, and subsequently underwent radical tumor resection, segmental right carotid artery resection, and deep femoral vein interposition. Recovery was complicated by hematoma formation, and the patient developed vocal fold paralysis and a left vocal fold cyst, necessitating further surgeries. Yearly follow-ups for 8 years revealed no recurrence. This case emphasizes the importance of comprehensive patient evaluation, including clinical history, imaging, and biopsy findings, for accurate diagnosis and prompt surgical intervention in managing such rare and aggressive tumors. Further research is needed to identify novel therapies and improve survival rates for patients with MTTs.

摘要

恶性蝾螈肿瘤(MTTs)是一种罕见且侵袭性的恶性外周神经鞘瘤(MPNSTs)亚型,常与神经纤维瘤病 1 型相关。本病例报告描述了一例 33 岁男性在颈动脉鞘内发生的复发性散发性 MTT,该患者无神经纤维瘤病的个人或家族史。患者最初表现为右侧颈部经活检证实的 MTT,累及颈动脉体和臂丛,接受了部分切除术、放射治疗和化疗。6 个月后,患者出现复发性 MTT,随后接受了根治性肿瘤切除术、右侧颈总动脉节段切除术和股深静脉间置术。恢复过程中出现血肿形成,患者发生声带麻痹和左侧声带囊肿,需要进一步手术。8 年来每年进行随访,未发现复发。本病例强调了对患者进行全面评估的重要性,包括临床病史、影像学和活检结果,以准确诊断和及时进行手术干预,从而治疗这种罕见且侵袭性的肿瘤。需要进一步研究以确定新的治疗方法并提高 MTT 患者的生存率。

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