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鼻咽部神经鞘瘤——一例表现复杂的罕见病例

Schwannoma of Nasopharynx-A Rare Case with A Complex Presentation.

作者信息

Srinivasan Dharanya Gopalakrishnan, Saxena Sunil Kumar, Kuppusamy Devi Anu, Jinkala Sreerekha

机构信息

Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2024 Feb;76(1):1321-1324. doi: 10.1007/s12070-023-04303-1. Epub 2023 Nov 4.

Abstract

Nasopharyngeal tumors are rare, and schwannomas originating from this location are extremely uncommon. Schwannomas are tumors arising from the Schwann cells of peripheral nerve sheath which are neuroectodermal in origin. These are benign, slow growing, well-encapsulated tumors and are mostly seen in the head and neck region. We present a rare case of schwannoma with nasopharynx as its epicenter in an elderly female patient who presented with complaints of hematemesis, bilateral nasal obstruction and stertorous breathing. Diagnostic nasal endoscopy revealed a smooth mucosa covered globular mass occupying bilateral choana. Contrast-enhanced computed tomography of Nose and paranasal sinuses revealed a homogenous mass occupying the entire nasopharynx extending into the nasal and oropharyngeal cavities. The patient underwent Trans-nasal Endoscopic excision under general anesthesia. Nasopharyngeal tumors have a wide range of presentation and a high index of clinical suspicion combined with imaging modalities is required for diagnosis and pre operative planning. Some tumors can cause life-threatening airway obstruction due to delayed presentation and should be managed efficiently and meticulously, with endoscopic excision being a viable approach for cases confined within the nasopharynx.

摘要

鼻咽部肿瘤较为罕见,起源于该部位的神经鞘瘤极其少见。神经鞘瘤是起源于神经外胚层的周围神经鞘雪旺细胞的肿瘤。这些是良性、生长缓慢、包膜完整的肿瘤,大多见于头颈部区域。我们报告一例罕见的以鼻咽部为中心的神经鞘瘤,患者为老年女性,主诉有呕血、双侧鼻塞及打鼾样呼吸。诊断性鼻内镜检查发现一个表面黏膜光滑的球形肿物占据双侧后鼻孔。鼻窦增强计算机断层扫描显示一个均匀的肿物占据整个鼻咽部,并延伸至鼻腔和口咽腔。患者在全身麻醉下接受了经鼻内镜切除术。鼻咽部肿瘤有多种表现形式,诊断和术前规划需要高度的临床怀疑并结合影像学检查方法。一些肿瘤由于就诊延迟可导致危及生命的气道梗阻,应进行有效且细致的处理,对于局限于鼻咽部的病例,内镜切除是一种可行的方法。

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