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隐匿为甲状腺肿瘤的颈部神经鞘瘤:深入诊断与解剖

Neck Schwannoma Masking as Thyroid Tumour: Into the Deep of Diagnostics and Anatomy.

作者信息

Covantsev Serghei, Bumbu Anna, Sukhotko Anna, Zakurdaev Evghenii, Kuts Ivan, Evsikov Andrey

机构信息

Department of Clinical Research and Development, Botkin Hospital, 125284 Moscow, Russia.

Department of Oncology, Botkin Hospital, 125284 Moscow, Russia.

出版信息

Diagnostics (Basel). 2024 Oct 19;14(20):2332. doi: 10.3390/diagnostics14202332.

Abstract

Schwannomas are benign nerve sheath tumours that exhibit a slow rate of growth. In the vast majority of cases, schwannomas manifest as asymptomatic masses. The presence of symptomatic lesions may necessitate surgical removal. The incidence of schwannomas ranges from 4.4 to 5.23 cases per 100,000 population, accounting for approximately 7% of all primary tumours in the central nervous system. There is a limited number of case reports describing schwannomas outside the central nervous system. In rare instances, schwannomas may originate at the level of the thyroid gland. In such cases, incidental neck schwannomas may be mistaken for thyroid or parathyroid tumours. The increasing incidence of thyroid cancer draws more attention to all thyroid nodules, both benign and malignant. Thyroid nodules are detected in up to 65% of autopsies, with only 4-6.5% being malignant. Thyroid tumours are typically diagnosed by USG; however, they are often revealed incidentally during neck CT or MRI for other conditions. To rule out malignancy, tumour verification is required. The modern diagnosis of thyroid cancer is based on fine-needle aspiration (FNA) biopsy and cytology, which is classified according to the Bethesda classification system. However, not all FNAs are informative, and the differential diagnosis and treatment strategies in cases of unsatisfactory results are not standardized, leading to potential intraoperative challenges. We present a case study of a patient with a thyroid nodule that was ultimately diagnosed with a schwannoma of the neck according to core-needle biopsy.

摘要

施万细胞瘤是一种生长缓慢的良性神经鞘瘤。在绝大多数情况下,施万细胞瘤表现为无症状肿块。有症状的病变可能需要手术切除。施万细胞瘤的发病率为每10万人中有4.4至5.23例,约占中枢神经系统所有原发性肿瘤的7%。描述中枢神经系统以外施万细胞瘤的病例报告数量有限。在罕见情况下,施万细胞瘤可能起源于甲状腺水平。在这种情况下,颈部偶然发现的施万细胞瘤可能会被误诊为甲状腺或甲状旁腺肿瘤。甲状腺癌发病率的上升使人们更加关注所有甲状腺结节,包括良性和恶性结节。在高达65%的尸检中可检测到甲状腺结节,其中只有4%至6.5%为恶性。甲状腺肿瘤通常通过超声检查诊断;然而,它们常常在因其他疾病进行颈部CT或MRI检查时被偶然发现。为排除恶性肿瘤,需要进行肿瘤验证。现代甲状腺癌的诊断基于细针穿刺(FNA)活检和细胞学检查,并根据贝塞斯达分类系统进行分类。然而,并非所有FNA检查都能提供有用信息,对于结果不理想的病例,鉴别诊断和治疗策略并不规范,这可能导致术中出现挑战。我们报告一例甲状腺结节患者的病例研究,该患者最终经粗针活检被诊断为颈部施万细胞瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e9aa/11508138/2e24d2881376/diagnostics-14-02332-g001.jpg

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