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恶性周围神经鞘膜瘤酷似颈动脉体瘤:一例罕见病例报告及文献复习

Malignant peripheral nerve sheath tumor mimicking carotid body tumor, a rare case report and review of literature.

作者信息

Kharazm Pezhman, Noruzi Soheil, Aghili Alireza, Zarbakhsh Ali, Azarhoosh Ramin, Maghsudloo Fereshteh

机构信息

Assistant Professor of Vascular Surgery, Clinical Research Development Center, 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

Vascular Surgeon, Clinical Research Development Center, 5 Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110406. doi: 10.1016/j.ijscr.2024.110406. Epub 2024 Oct 2.

Abstract

INTRODUCTION AND IMPORTANCE

Malignant Peripheral Nerve Sheath Tumor (MPNST) is a rare type of soft tissue sarcoma. It is an aggressive tumor with high rates of local recurrence and distant metastasis. MPNST rarely occurs in the neck. We present a case of cervical MPNST manifesting as Carotid Body Tumor (CBT).

CASE PRESENTATION

A 67-year-old man presented with a neck mass. The mass was rapidly enlarging and imaging studies favored CBT. A previous attempt at surgical resection failed, and the compressive symptoms were progressive during recent weeks. After multidisciplinary discussion, the tumor was resected and pathological evaluation confirmed the diagnosis of MPNST. Post-operative metastatic work-up showed lung metastasis, and the patient died approximately one year after surgery.

CLINICAL DISCUSSION

Cervical MPNST is rare, and surgery is the mainstay of its treatment. Pre-operative tissue diagnosis is recommended when possible, and immunohistochemical staining is necessary for prompt diagnosis. Adjuvant therapy may be helpful in metastatic cases or incomplete resection. Nevertheless, local recurrence and distant metastasis especially to the lungs are common, as in our case.

CONCLUSION

MPNST is one of the potential causes of cervical masses and considering its invasive behavior, surgical resection is recommended as soon as the diagnosis is made.

摘要

引言与重要性

恶性外周神经鞘瘤(MPNST)是一种罕见的软组织肉瘤。它是一种侵袭性肿瘤,局部复发率和远处转移率都很高。MPNST很少发生在颈部。我们报告一例表现为颈动脉体瘤(CBT)的颈部MPNST病例。

病例介绍

一名67岁男性因颈部肿块就诊。肿块迅速增大,影像学检查倾向于CBT。此前的手术切除尝试失败,且近几周压迫症状逐渐加重。经过多学科讨论后,切除了肿瘤,病理评估确诊为MPNST。术后转移检查显示有肺转移,患者术后约一年死亡。

临床讨论

颈部MPNST罕见,手术是其主要治疗方法。建议尽可能进行术前组织诊断,免疫组化染色对于快速诊断是必要的。辅助治疗可能对转移病例或切除不完全的病例有帮助。然而,如我们的病例所示,局部复发和远处转移尤其是肺转移很常见。

结论

MPNST是颈部肿块的潜在病因之一,考虑到其侵袭性行为,一旦确诊建议尽早进行手术切除。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6f4/11471188/8477a64bd775/gr1.jpg

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