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下肢快速生长的平滑肌瘤酷似大隐神经鞘瘤:一例罕见病例报告。

Rapidly Growing Leiomyoma Mimicking Schwannoma of the Saphenous Nerve in the Lower Extremity: An Unusual Case Report.

机构信息

Department of Neurosurgery, University of Health Sciences, Kayseri City Hospital, Kayseri, Turkey.

Department of Pathology, University of Health Sciences, Kayseri City Hospital, Kayseri, Turkey.

出版信息

J Musculoskelet Neuronal Interact. 2024 Sep 1;24(3):325-329.

Abstract

Leiomyomas and schwannomas are both types of rare benign soft tissue tumours. Leiomyomas are more commonly found in the lower limbs than in the upper extremities, while schwannomas are rare peripheral nerve sheath tumours that can occur in different anatomical regions. However, they rarely occur in the saphenous nerve. This case study presents a 41-year-old female patient with a solitary mass lesion located deep in the soft tissue of the anteromedial lower extremity. The physical examination revealed a palpable, elastic-hard, mobile and non-tender mass. Magnetic resonance imaging (MRI) showed an oval-shaped subcutaneous mass on contrast-enhanced T1-weighted sections. The initial MRI images suggested a schwannoma, but the tumour was later confirmed to be a leiomyoma after total enucleation. An immunohistochemical study was performed for differential diagnosis. Solitary mass lesions in the lower extremities can be mistaken for various types of tumours and misdiagnosed and require histopathological examination and good radiological imaging for differential diagnosis. Complete surgical excision is usually a safe and effective treatment for leiomyomas.

摘要

平滑肌瘤和神经鞘瘤均为罕见的良性软组织肿瘤。平滑肌瘤较常见于下肢,而上肢较少见,而神经鞘瘤则是一种罕见的周围神经鞘肿瘤,可发生于不同的解剖部位。然而,它们很少发生在隐神经上。本病例研究报告了一位 41 岁女性患者,其前内侧下肢深部软组织中存在单发肿块病变。体格检查发现可触及、弹性硬、可移动且无触痛的肿块。磁共振成像(MRI)显示增强 T1 加权切片上呈椭圆形皮下肿块。初始 MRI 图像提示为神经鞘瘤,但肿瘤在完全剜除后被证实为平滑肌瘤。进行了免疫组织化学研究以进行鉴别诊断。下肢单发肿块病变可能被误诊为各种类型的肿瘤,需要进行组织病理学检查和良好的影像学检查以进行鉴别诊断。完整的手术切除通常是治疗平滑肌瘤的安全有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b6eb/11367172/b77fd1fc10a4/JMNI-24-325-g001.jpg

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