Perzin K H, Panyu H, Wechter S
Cancer. 1982 Nov 15;50(10):2193-202. doi: 10.1002/1097-0142(19821115)50:10<2193::aid-cncr2820501036>3.0.co;2-0.
Twelve Schwann cell tumors (two neurilemomas, six neurofibromas, and four malignant schwannomas), arising in the nasal cavity, paranasal sinuses or nasopharynx, are described. Schwann cell neoplasms only rarely develop in this area. Clinically, these tumors lead to nonspecific symptoms including nasal obstruction epistaxis, facial pain and swellling, and proptosis, similar to those produced by other neoplasms that involve this area. On radiologic examination, a mass lesion may be identified. Benign Schwann cell tumors may lead to bone erosion, which thus is not necessarily a sign of malignancy. The correct diagnosis of Schwann cell tumor is usually made only when histologic sections are studied. The histologic differentiation between Schwann cell neoplasms and myxomas, fibroblastic tumors, fibrous histiocytomas and fibro-osseous lesions is discussed. Treatment depends upon the type of tumor. Neurilemomas, which usually are encapsulated neoplasms, can be treated by local excision. Neurofibromas may infiltrate extensively, and thus may require an extensive surgical resection; however, functional and cosmetic considerations should be taken into account because neurofibromas, even if incompletely excised, may recur clinically only after many years. Malignant schwannomas tend to be aggressive neoplasms, but because of the anatomy of the area, radical resections leading to complete removal of the tumor cannot always be carried out.
本文描述了12例发生于鼻腔、鼻窦或鼻咽部的施万细胞瘤（2例神经鞘瘤、6例神经纤维瘤和4例恶性施万细胞瘤）。施万细胞瘤在该区域很少发生。临床上，这些肿瘤会导致非特异性症状，包括鼻塞、鼻出血、面部疼痛和肿胀以及眼球突出，与该区域其他肿瘤产生的症状相似。在影像学检查中，可发现肿块病变。良性施万细胞瘤可能导致骨质侵蚀，因此骨质侵蚀不一定是恶性的迹象。通常只有在研究组织切片时才能做出施万细胞瘤的正确诊断。本文还讨论了施万细胞瘤与黏液瘤、成纤维细胞瘤、纤维组织细胞瘤和骨纤维性病变在组织学上的鉴别。治疗取决于肿瘤的类型。神经鞘瘤通常是有包膜的肿瘤，可通过局部切除进行治疗。神经纤维瘤可能广泛浸润，因此可能需要广泛的手术切除；然而，应考虑功能和美容因素，因为神经纤维瘤即使未完全切除，临床上可能多年后才会复发。恶性施万细胞瘤往往是侵袭性肿瘤，但由于该区域的解剖结构，导致肿瘤完全切除的根治性手术并不总是能够实施。
