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左上肢罕见多发神经鞘瘤:一例报告

Rare multiple schwannomas of the left upper extremity: A case report.

作者信息

Chen Huan, Yao Xiguan, Wang Peigeng, Xu Yude, Yao Yicun, Yang Weichao, Liu Yiming, Luo Wei, Tan Yong, Lin Jinzhi, Leng Lei, Miao Haixiong, Ye Dongping

机构信息

Department of Orthopedics, The First Clinical Medical College, Guangdong Medical University, Zhanjiang, Guangdong 524023, P.R. China.

Department of Orthopedics, Guangzhou Red Cross Hospital of Jinan University, Guangzhou, Guangdong 510220, P.R. China.

出版信息

Oncol Lett. 2025 Mar 4;29(4):205. doi: 10.3892/ol.2025.14952. eCollection 2025 Apr.

Abstract

Schwannomas are rare benign neoplasms originating from Schwann cells of peripheral nerve sheaths. The current study presents a distinctive case involving multiple schwannomas along the peripheral nerves of the left upper extremity. The patient exhibited multiple gradually enlarging subcutaneous masses distributed along the nerves of the left upper limb, without pain, neurological deficits or a positive Tinel's sign upon physical examination. Preoperative diagnostic imaging, including high-resolution ultrasonography and magnetic resonance imaging, revealed well-circumscribed, homogeneous soft-tissue masses with characteristic features. Despite these findings, imaging modalities demonstrated limited specificity in conclusively differentiating the upper extremity tumors from other soft-tissue neoplasms. Surgical exploration conducted under general anesthesia identified three encapsulated masses with focal capsular discontinuities, adherent to surrounding skeletal muscle and the median nerve. The masses measured 6×5×3, 5×4×3.5 and 5×3.5×3 cm from proximal to distal, respectively. Complete surgical excision was performed with meticulous preservation of adjacent neurovascular structures. Histopathological analysis confirmed the diagnosis of schwannomas. This report also provides an extensive review of the literature addressing the etiology, clinical presentation, diagnostic techniques and treatment strategies for peripheral nerve schwannomas, contributing to a deeper understanding of this rare neurogenic tumor and aiding in its effective clinical management.

摘要

施万细胞瘤是起源于周围神经鞘雪旺细胞的罕见良性肿瘤。本研究报告了一例独特病例,患者左上肢周围神经出现多发施万细胞瘤。患者左上肢神经沿线出现多个逐渐增大的皮下肿块,体格检查时无疼痛、神经功能缺损或Tinel征阳性。术前诊断性影像学检查,包括高分辨率超声和磁共振成像,显示边界清晰、均匀的软组织肿块,具有特征性表现。尽管有这些发现,但影像学检查在明确区分上肢肿瘤与其他软组织肿瘤方面的特异性有限。全身麻醉下进行的手术探查发现三个包膜完整的肿块,包膜有局灶性连续性中断,与周围骨骼肌和正中神经粘连。肿块从近端到远端分别为6×5×3、5×4×3.5和5×3.5×3厘米。手术完整切除肿块,并精心保留相邻的神经血管结构。组织病理学分析确诊为施万细胞瘤。本报告还对周围神经施万细胞瘤的病因、临床表现、诊断技术和治疗策略进行了广泛的文献综述,有助于更深入地了解这种罕见的神经源性肿瘤,并辅助其有效的临床管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/00ac/11894517/12d0556a4782/ol-29-04-14952-g00.jpg

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