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[额下神经鞘瘤:一例报告]

[Subfrontal schwannoma: report of a case].

作者信息

Sato S, Toya S, Nakamura T, Ohtani M, Imanishi T, Kodaki K, Nakamura Y

出版信息

No Shinkei Geka. 1985 Aug;13(8):883-7.

PMID:4058665
Abstract

Subfrontal schwannoma is extremely uncommon. By reviewing the literature, we are able to find 8 previously described cases. This report describes a very rare case of solitary schwannoma grown in the anterior cranial fossa. A patient, 23 years old male, had experienced generalized convulsion on April 4, 1981. On the Tc99m scintigram, accumulation of isotope was observed in the left anterior cranial fossa. The carotid angiography revealed that the tumor stain was supplied from ophthalmic artery and orbitofrontal artery. CT showed an area with relatively low density in the left frontal base. This area was well enhanced following contrast injection. Coronal CT revealed that the tumor was contiguous with the left olfactory groove. The tumor was removed on May 12, 1981. The left fronto-temporal post-operative epidural hematoma was observed after the operation but his post-operative course was relatively satisfactory. Histological section of tumor showed interwinning bundles of cells with pallisading on hematoxylin and eosin. Pathological study showed such pallisading of the tumor cells, which confirmed that the tumor was schwannoma. While the precise origin of this unusually situated schwannoma remains uncertain, it appears most likely that the origin was from either ectopic, or perivascular nerve plexus schwann cells or dural branch of trigeminal nerve. Because the branch of the trigeminal nerves or anterior ethmoidal nerves is distributed to the meninges, the trigeminal nerve is covered with schwann cells after penetrating the pia mater in the anterior cranial fossa.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

额下神经鞘瘤极为罕见。通过查阅文献,我们找到了8例先前描述的病例。本报告描述了1例生长在前颅窝的极为罕见的孤立性神经鞘瘤。1例23岁男性患者于1981年4月4日出现全身性惊厥。在锝99m闪烁扫描中,观察到左前颅窝有同位素聚集。颈动脉血管造影显示肿瘤染色由眼动脉和眶额动脉供血。CT显示左额叶底部有一相对低密度区。注入造影剂后该区域强化明显。冠状位CT显示肿瘤与左嗅沟相邻。肿瘤于1981年5月12日切除。术后观察到左额颞部硬膜外血肿,但他的术后病程相对满意。肿瘤组织学切片在苏木精和伊红染色下显示细胞呈交织束状并伴有栅栏状排列。病理研究显示肿瘤细胞有这种栅栏状排列,证实该肿瘤为神经鞘瘤。虽然这个位置异常的神经鞘瘤的确切起源仍不确定,但最有可能的起源是异位的、血管周围神经丛施万细胞或三叉神经的硬脑膜分支。因为三叉神经分支或筛前神经分布到脑膜,三叉神经在前颅窝穿透软脑膜后被施万细胞覆盖。(摘要截短至250字)

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