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腋窝周围神经鞘瘤:躯干中的罕见病例。

Axillary Peripheral Nerve Schwannoma: A Rare Occurrence in the Torso.

作者信息

Inayath Syed Ahmed, Patil Sachin, Zakkir Sneha

机构信息

Department of General Surgery, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, IND.

出版信息

Cureus. 2024 Nov 13;16(11):e73622. doi: 10.7759/cureus.73622. eCollection 2024 Nov.

Abstract

A schwannoma is a benign, solitary, noninvasive, and encapsulated tumor that originates from Schwann cells of the peripheral nerve sheath commonly found in the head and neck. A rare case of a benign schwannoma in the axillary region of a 34-year-old male patient is presented here accompanied by a discussion on the known entities of peripheral nerve schwannoma as well as the clinical and radiological findings coupled with treatment techniques. The patient presented with a left axillary mass of seven years gradually progressing in size which is associated with pain in the left arm. There were no neurological deficits on examination. Ultrasound and soft tissue MRI were performed followed by fine-needle aspiration cytology (FNAC), and a decision was made to take the patient up for an excisional biopsy. Histopathology revealed a tumor composed of hyper- (Antoni A) and hypocellular (Antoni B) areas, while immunohistochemistry was positive for the S-100 protein, thus confirming the diagnosis of left axillary peripheral nerve schwannoma. With such nonspecific presentation and the added challenge of its rarity, an axillary schwannoma may be easily missed and mismanaged. Surgical excision and biopsy are recommended with an aim of preserving neurological function.

摘要

施万细胞瘤是一种良性、孤立、非侵袭性的包膜肿瘤,起源于头颈部常见的周围神经鞘膜的施万细胞。本文介绍了一例34岁男性患者腋窝区域罕见的良性施万细胞瘤病例,并讨论了周围神经施万细胞瘤的已知情况、临床和影像学表现以及治疗技术。该患者左腋窝肿物已存在7年,大小逐渐增大,伴有左臂疼痛。检查时未发现神经功能缺损。进行了超声和软组织MRI检查,随后进行了细针穿刺细胞学检查(FNAC),并决定对患者进行切除活检。组织病理学显示肿瘤由高细胞区(Antoni A)和低细胞区(Antoni B)组成,免疫组织化学检查S-100蛋白呈阳性,从而确诊为左腋窝周围神经施万细胞瘤。由于临床表现不具特异性且该病罕见,腋窝施万细胞瘤很容易被漏诊和误诊。建议进行手术切除和活检,以保留神经功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07dc/11645165/a37895f75fd2/cureus-0016-00000073622-i01.jpg

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