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伴有中风风险的颈迷走神经无症状性神经鞘瘤的非常规手术切除:病例报告

Unusual Surgical Resection of Asymptomatic Schwannoma of the Cervical Vagus Nerve With Risk of Stroke: Case Report.

作者信息

Martins Roberto Sérgio, de Oliveira Adilson J M, Lucas Evander, Siqueira Mario Gilberto

机构信息

Peripheral Nerve Surgery Unit, Division of Neurosurgery, Hospital das Clínicas, Faculty of Medicine, São Paulo University, São Paulo, Brazil.

Centro de Estudos Avançados em Formação e Educação Médica-CEDUMED, Faculty of Medicine, Agostinho Neto University, Luanda, Angola.

出版信息

Case Rep Surg. 2025 Jan 23;2025:9443139. doi: 10.1155/cris/9443139. eCollection 2025.

Abstract

Schwannomas are the most common tumors of the peripheral nerves, originating from their support cells, the Schwann cells. The location of the tumor in the vagus nerve is rare. Vagus schwannomas usually present as a solitary, slow-growing, asymptomatic mass that rarely causes neurological alterations. The differential diagnosis of vagus nerve schwannomas includes other tumors of the parapharyngeal space or neoplasms of the jugular foramen. We report the case of a patient with an asymptomatic schwannoma of the vagus nerve involving important neck structures, with radiological compression of the carotid artery with a high risk of stroke; because of this, we underwent surgery using a transcervical approach with intracapsular excision of the tumor. The patient has a good outcome. In asymptomatic patients' surgical indication is not an easy decision; in this case, the main reason for surgical indication was the risk of stroke with potential neurological sequels.

摘要

施万细胞瘤是周围神经最常见的肿瘤,起源于其支持细胞——施万细胞。肿瘤位于迷走神经的情况较为罕见。迷走神经施万细胞瘤通常表现为单个、生长缓慢、无症状的肿块,很少引起神经功能改变。迷走神经施万细胞瘤的鉴别诊断包括咽旁间隙的其他肿瘤或颈静脉孔肿瘤。我们报告了一例患有迷走神经无症状施万细胞瘤的患者,该肿瘤累及重要的颈部结构,对颈动脉造成放射学压迫,存在较高的中风风险;因此,我们采用经颈入路对肿瘤进行囊内切除手术。患者预后良好。对于无症状患者,手术指征并非易事;在本病例中,手术指征的主要原因是存在中风风险及潜在的神经后遗症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76fe/11824593/cc02437cc590/CRIS2025-9443139.001.jpg

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