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喉神经鞘瘤伪装为恶性肿瘤。

Laryngeal schwannoma masquerading as malignancy.

机构信息

All India Institute of Medical Sciences - Mangalagiri, Guntur, Andhra Pradesh, India

All India Institute of Medical Sciences - Mangalagiri, Guntur, Andhra Pradesh, India.

出版信息

BMJ Case Rep. 2024 Jul 16;17(7):e260258. doi: 10.1136/bcr-2024-260258.

Abstract

Laryngeal schwannoma is a rare type of neurogenous tumour with a non-specific presentation. We present a case of a middle-aged man with issues of hoarseness, globus sensation and intermittent episodes of throat pain. The Hopkins examination showed right vocal fold irregularity with fullness in the right ventricle. The contrast-enhanced CT neck revealed an ill-defined lesion with contrast uptake extending into the paraglottic region with no neck node involvement. Considering the clinical presentation of hoarseness, throat pain and globus with imaging revealing contrast enhancement of lesion, direct laryngoscopy and biopsy were planned to rule out malignancy. Intraoperatively, a well-defined submucosal capsulated swelling became apparent after incision and dissection of the mucosa over the right vocal fold. A complete excision of the swelling was done with microlaryngeal instruments without tracheostomy. The histopathological report was suggestive of schwannoma. The literature review discusses clinical presentation, location, imaging features and management strategy.

摘要

喉神经鞘瘤是一种罕见的神经源性肿瘤,临床表现不具特异性。我们报告了 1 例中年男性患者,主要表现为声音嘶哑、咽部异物感和间歇性咽喉疼痛。Hopkins 检查显示右侧声带不规则,右侧杓状软骨饱满。颈部增强 CT 显示病变边界不清,增强后延伸至声门旁间隙,无颈部淋巴结受累。鉴于声音嘶哑、咽喉疼痛和咽部异物感的临床表现,以及影像学显示病变增强,计划进行直接喉镜检查和活检以排除恶性肿瘤。术中,在切开并剥离右侧声带黏膜后,发现一个界限清楚的黏膜下被膜性肿胀。使用显微喉镜器械完整切除了该肿胀,未行气管切开术。组织病理学报告提示为神经鞘瘤。文献复习讨论了其临床表现、位置、影像学特征和治疗策略。

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