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穿越迷宫:腹部手术后罕见肿瘤引发的乳糜胸和乳糜腹水揭秘

Navigating the Labyrinth: Chylothorax and Chylous Ascites Unveiled After Abdominal Surgery for an Exceptionally Rare Tumor.

作者信息

Umar Anam, Faquih Amber E, Bilal Muhammad, Garner Jeffery

机构信息

Internal Medicine, Ascension St. Vincent's Birmingham, Birmingham, USA.

Infectious Diseases, University of Alabama at Birmingham, Birmingham, USA.

出版信息

Cureus. 2024 Aug 5;16(8):e66239. doi: 10.7759/cureus.66239. eCollection 2024 Aug.

DOI:10.7759/cureus.66239
PMID:39238722
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11375108/
Abstract

Schwannomas, originating from the Schwann sheath of peripheral or cranial nerves, are rare tumors commonly found in the head and neck or extremities. Adrenal schwannomas, however, are exceedingly rare, accounting for less than 1% of all adrenal tumors. Here, we present a case of a 31-year-old Caucasian woman diagnosed with an adrenal schwannoma, which was incidentally discovered during imaging studies for an unrelated issue. Following laparoscopic adrenalectomy, the patient developed chylous ascites (CA) and coexistent chylothorax, posing a diagnostic challenge and necessitating a multidisciplinary approach to management.

摘要

神经鞘瘤起源于周围神经或颅神经的施万鞘,是罕见肿瘤,常见于头颈部或四肢。然而,肾上腺神经鞘瘤极为罕见,占所有肾上腺肿瘤的比例不到1%。在此,我们报告一例31岁的白种女性,被诊断为肾上腺神经鞘瘤,该肿瘤是在针对无关问题进行影像学检查时偶然发现的。腹腔镜肾上腺切除术后,患者出现乳糜性腹水(CA)并伴有乳糜胸,这带来了诊断挑战,需要多学科方法进行管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/81aa5e1dc324/cureus-0016-00000066239-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/0b1f0c20bce8/cureus-0016-00000066239-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/376095b07ce4/cureus-0016-00000066239-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/15e5da48b5aa/cureus-0016-00000066239-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/9140ab4419e5/cureus-0016-00000066239-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/81aa5e1dc324/cureus-0016-00000066239-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/0b1f0c20bce8/cureus-0016-00000066239-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/376095b07ce4/cureus-0016-00000066239-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/15e5da48b5aa/cureus-0016-00000066239-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/9140ab4419e5/cureus-0016-00000066239-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2f/11375108/81aa5e1dc324/cureus-0016-00000066239-i05.jpg

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本文引用的文献

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Giant benign intrathoracic schwannoma: a decade-long progression towards fatality.巨大良性胸内神经鞘瘤:长达十年的致死性进展。
J Cardiothorac Surg. 2023 Nov 14;18(1):328. doi: 10.1186/s13019-023-02375-2.
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Adrenal Schwannoma: Case Description and Diagnostic Pointers of a Rare Disease.肾上腺神经鞘瘤:一种罕见疾病的病例描述及诊断要点
Cureus. 2023 Feb 1;15(2):e34485. doi: 10.7759/cureus.34485. eCollection 2023 Feb.
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A Rare Case of an Adrenal Schwannoma.一例罕见的肾上腺神经鞘瘤
Cureus. 2023 Jan 12;15(1):e33710. doi: 10.7759/cureus.33710. eCollection 2023 Jan.
4
Postoperative chylous ascites after total gastrectomy successfully treated using peritoneovenous (Denver) shunt: a case report.经腹膜静脉(丹佛)分流术成功治疗全胃切除术后乳糜性腹水:一例报告
Surg Case Rep. 2022 May 10;8(1):92. doi: 10.1186/s40792-022-01447-0.
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Adrenal Schwannoma: A Case Report.肾上腺神经鞘瘤:一例报告
Int Med Case Rep J. 2021 Sep 7;14:617-620. doi: 10.2147/IMCRJ.S311777. eCollection 2021.
6
Adrenal Schwannoma in an Elderly Man: A Case Report and Literature Review.老年男性肾上腺神经鞘瘤 1 例报告并文献复习
Intern Med. 2022 Jan 1;61(1):65-69. doi: 10.2169/internalmedicine.7026-21. Epub 2021 Jun 26.
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Schwannoma originating in the soft palate: A case report.起源于软腭的神经鞘瘤:一例报告。
Int J Surg Case Rep. 2021 Jul;84:106108. doi: 10.1016/j.ijscr.2021.106108. Epub 2021 Jun 17.
8
Recurrent Chylous Ascites Leading to Transudative Chylothorax Due to Bi-Ventricular Heart Failure.因双心室心力衰竭导致复发性乳糜性腹水进而引发漏出性乳糜性胸水。
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211026144. doi: 10.1177/23247096211026144.
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Bilateral Chylothorax and Chylous Ascites: A Rare Presentation of an Uncommon Disorder.双侧乳糜胸和乳糜性腹水:一种罕见疾病的罕见表现
Cureus. 2021 Mar 22;13(3):e14044. doi: 10.7759/cureus.14044.
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Adrenal schwannoma: a case report.肾上腺神经鞘瘤:一例报告
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