胃神经鞘瘤:附9例报告

目的 分析胃神经鞘瘤的临床特点、诊断和治疗方法。方法 回顾分析笔者近15年来收治的9例胃神经鞘瘤的临床资料。结果 临床主要表现是上腹部隐痛(9例)、腹部肿块(5例)和上消化道出血(3例)。9例均手术治疗，但无1例术前确诊。1例恶性胃神经鞘瘤术后只生存了8个月，良性的手术效果良好。结论 胃神经鞘瘤无特异性临床表现，术前确诊困难，误诊率高，一经确诊，应及早手术治疗。     

Angiosarcoma Developing in a Vagal Schwannoma: A Rare Case Report

Angiosarcoma arising in a schwannoma is extremely rare with only fourteen cases having been reported in the literature to the best of our knowledge. Amongst these fourteen, only five cases developed from vagal schwannoma. We describe a case of epithelioid angiosarcoma arising in a long standing vagal schwannoma in a 41 years male patient. Grossly the tumor was well encapsulated with variegated cut surface. On microscopy the tumor had two distinct components composed of benign schwannoma and malignant angiosarcoma which were further confirmed by immunohistochemistry. On further work up, he was found to have multiple distant metastases. This is the sixth reported case of angiosarcoma arising in a vagal schwannoma. The proposed histogenesis of this rare transformation, its prognostic factors and a review of literature regarding this entity is discussed.     

Cystic schwannoma of the cauda equina mimicking hemangioblastoma

Cystic schwannoma is highly unusual and intraspinal involvement seems to be even more rare. We report a case of intradural lumbar-cystic schwannoma in a 50-year-old man who presented with chronic low-back pain and sciatalgia, which were initially related to a bulging disc. Diagnosis of a tumor origin was suspected two years later on MRI as a hemangioblastoma. The lesion was histologically confirmed to be a schwannoma. Only eight cases of spinal schwannoma with large cyst have been previously reported. Cystic schwannoma should be considered in the differential diagnosis of lumbar intradural-cystic lesion.     

胃神经鞘瘤

目的 总结胃神经鞘瘤的临床特点及治疗方法。方法 收集经我院诊治的10例胃神经鞘瘤患的资料,对其诊断及治疗作分析总结。结果 胃神经鞘瘤主要表现为腹痛、腹部肿块、黑便、上消化道出血亲休克。可通过胃镜、X线、B超等辅助检查协助诊断,确诊靠病理检查。治疗以手术为主。结论 胃神经鞘瘤无特殊临床表现,诊断困难,术前确诊率低,误诊率高。     

周围神经鞘瘤的显微外科治疗

目的：探讨周围神经鞘瘤显微手术治疗的效果。方法回顾性分析54例经显微手术切除神经鞘瘤的疗效。结果本组54例均取得良好效果。经过1～2年的随访,5例恶性神经鞘瘤无复发;良性神经鞘瘤,1例术后出现皮肤感觉麻木,3例出现运动功能障碍,6个月后基本恢复。结论周围神经鞘瘤经显微手术治疗可最大限度地降低神经的损伤,可最大程度地完整切除肿瘤,对于恶性神经鞘瘤,扩大切除可降低复发。     

Intrathoracic vagal nerve schwannoma preoperative diagnosis is correct because of clinical and characteristic ct findings —A case report and review of the literature—

A 60-year-old man was operated with the clinical diagnosis of intrathoracic vagal nerve schwannoma because of characteristic CT findings and no symptom of neurofibromatosis. Thoracoscopic surgery was performed and it was confirmed pathologically. Intrathoracic vagal nerve tumor is rare, so preoperative diagnosis seems to be difficult. We review the intrathoracic vagal nerve tumors reported in Japan (52 cases of schwannoma and 9 cases of neurofibroma), and analyzed the tumor location, furthermore, the relationship of neurofibromatosis and schwannoma and neurofibroma on vagal nerve tumor.     

Laparoscopic resection of retroperitoneal schwannoma : report of three cases and review of 22 cases in Japanese literature

Retroperitoneal schwannoma is a rare tumor. Only 19 cases have been reported to be treated by laparoscopic surgery. We performed successful laparoscopic excision of retroperitoneal schwannoma using the four-trocar in three patients who had a left retroperitoneal mass. The patients were two women and one man. They were 62, 60 and 57 years old. The tumor was 70, 45 and 50 mm in greatest diameter and operative time was 204, 243 and 254 min. respectively. The pathological diagnosis of the tumor was schwannoma. There was no morbidity or mortality. Preoperative diagnosis of schwannoma is very difficult. However schwannoma is a benign tumor with a good prognosis. This laparoscopic excision for retroperitoneal schwannoma is effective and rather safe.     

Pancreatic schwannoma: Report of a case and review of literature

Connective tissue tumors of pancreas are uncommon, among them pancreatic schwannoma is very rare tumor, very few cases were reported in literature. Aggressive resections like whipple’s procedure, or distal pancreatectomy are not necessary for pancreatic schwannoma as it rarely goes to malignant change and simple enuclation is sufficient.In our patient pancreatic schwannoma is associated with simple cyst in liver and absence of one kidney. Here, we are presenting a case of pancreatic schwannoma treated by simple enucleation.     

Schwannoma of the adrenal gland: report of two cases

Primary schwannomas of the adrenal gland are extremely uncommon. We report the clinical and pathologic features of two cases, occurring in a 73-year-old man and a 26-year-old woman, both of whom presented with abdominal pain and an adrenal mass on imaging studies. Both tumors were characterized by a proliferation of cytologically bland spindle cells. One case exhibited alternating compact Antoni A areas and less cellular Antoni B areas consistent with conventional schwannoma, whereas the other case was hypercellular and composed predominantly of Antoni A areas consistent with cellular schwannoma. Reactive inflammatory cells and lymphoid aggregates were present throughout both tumors. The diagnosis of schwannoma was supported by positive immunoreactivity for S-100 protein and collagen IV and absence of reactivity for keratin, muscle related antigens, and CD34 in both cases. Electron microscopy was also performed in the case of cellular schwannoma, which showed ultrastructural features confirming the diagnosis. Both cases had a favorable outcome without evidence of recurrence or metastasis. Because of its rarity, schwannoma occurring at this particular site can pose problems in diagnosis and should be distinguished from other spindle cell lesions of the adrenal gland.     

Peripheral Nerve Schwannoma: A Review of Varying Clinical Presentations and Imaging Findings

A schwannoma or neurilemmoma is a benign, isolated, noninvasive, and encapsulated tumor originating from Schwann cells of the peripheral nerve sheath. The incidence of a schwannoma occurring in the foot and ankle is rare, with prevalence rate of 1% to 10%. Schwannomas have no sex predilection, and they commonly occur in patients in their fourth decade. Malignant transformation of benign schwannoma is unusual; however, it is important to note that malignant variants of schwannomas do exist and account for about 5% to 10% of all soft tissue sarcomas. We present 3 cases of benign schwannoma in the lower extremity. All 3 patients presented with varying clinical symptoms, including pain, paresthesia, weakness, and a palpable mass. A schwannoma was eventually diagnosed in all 3 patients. We discuss and review the known entities of peripheral nerve schwannoma and describe the clinical and imaging findings and therapeutic strategies for treating and diagnosing peripheral nerve schwannoma.     

Intraosseous schwannoma of the middle phalanx.

Intraosseous schwannoma is an extremely rare, benign neoplasm. Only a few cases involving the bones of the hand have been reported, and none of these cases has involved middle phalanx. We present a case of intraosseous schwannoma of the middle phalanx of the right ring finger.     

Malignant metastatic perirenal schwannoma

Only seven cases of malignant renal or perirenal schwannomas have previously been reported in the literature. Herein we report the case of a 74-year-old female with a previous history of malignant subcutaneous schwannoma and breast ductal adenocarcinoma who presented with a renal mass that was preoperatively diagnosed as a metastatic schwannoma. This is the first case of malignant perirenal schwannoma of metastatic origin.     

胃肠道神经鞘瘤的诊断及治疗

目的 分析胃肠道神经鞘瘤的发病概况并探讨其诊治方法。方法 对１２例胃肠道神经鞘瘤进行回顾性分析并文献复习。结果 术前确诊仅１例,手术切除１０例,术中活检２例;良性５年,２年内死于伴发病２例,存活已〉２年３例;恶性４例,１年及３年内死亡各为３例及１例;恶变倾向３例,２年内死亡１例,已存活〉６年２例。结论 胃肠道神经鞘瘤术前诊断困难,确诊靠病理,免疫组化检查有助于与平滑肌瘤鉴别。良性者可行局部切除,恶     

Malignancy in a vestibular schwannoma. Report of a case with central neurofibromatosis,treated by both stereotactic radiosurgery and surgical excision,with a review of the literature

Malignant change in schwannoma is rare. Malignant change in a vestibular schwannoma (acoustic neuroma) is even more rare. This paper presents a case of rapidly growing vestibular schwannoma first treated by radiosurgery whose histopathology after surgical excision 42 months later showed malignant changes. Up to now, eight cases of malignancy in eighth nerve tumours have been reported, four of which, including the present case, had previously been treated with radiosurgery and four cases that had not received radiation. Thus, it would seem, the overall incidence is extremely low. Nevertheless, extreme vigilance and careful reporting continues to be necessary.     

Large facial nerve schwannomas without facial palsy: case reports and review of the literature

Although approximately 30% of facial nerve schwannoma cases present with no facial palsy, a large facial nerve schwannoma extending to the middle and posterior cranial fossa quite rarely presents without facial palsy. The authors encountered two patients with large facial nerve schwannoma who presented with only hearing impairment and no facial palsy. The first patient was a 64-year-old woman who presented with right auditory impairment without facial palsy. MR images demonstrated a dumbbell-shaped tumor in the cerebellopontine angle. Another patient, a 40-year-old woman, also presented with vertigo and right tinnitus without facial palsy. MR images demonstrated a huge tumor expanding into both the posterior cranial fossa and middle cranial fossa. In both cases, intraoperative findings confirmed that the tumors had grown from the facial nerve. Facial nerve schwannoma can be easily diagnosed if detailed neurological evaluations and appropriate neuroimagings are conducted. However, in spite of such huge tumoral size and expanding pattern, the facial nerve function was relatively preserved. Anatomical features of the facial schwannoma are discussed. A tumor extending to the middle and posterior cranial fossa should remind neurosurgeons to consider facial nerve schwannomas even in the absence of facial palsy.     

Primary schwannoma of the thyroid gland involving the isthmus: report of a case

Primary thyroid schwannomas are extremely rare tumors and there are very few reports of such tumors in the literature. This report presents a rare case of schwannoma involving the isthmus of the thyroid in a 47-year-old male, presenting as a symptomatic predominating cold nodule within a multinodular goiter. The patient underwent total thyroidectomy. The histological examination indicated an Antoni A-type schwannoma. The clinical, radiological and pathological findings of the tumor are discussed, emphasizing the difficulty in reaching a correct preoperative diagnosis. Only 18 cases of primary schwannoma of the thyroid gland have so far been described in the literature and, this is only the second report of thyroid schwannoma localized in the isthmus.     

Primary spinal malignant schwannoma: Clinical,histological and cytogenetic findings

Of the 19 patients who presented between 1980 and 1990 to the Department of Neurosurgery, University of Hamburg, F. R. G. with malignant schwannoma, 5 patients suffered from primary malignant spinal schwannoma (mean age 44 years, only one patient with von Recklinghausen's disease). Here we report the clinical, histological, and cytogenetic features of the five cases with primary malignant spinal schwannoma and discuss the prognostic aspects of this rare tumor.     

Giant foot schwannoma.

Schwannoma of the foot is rare; only 12 cases have been reported. A schwannoma is a benign neurogenic tumour derived from Schwann cells. The diagnosis is often delayed because the symptoms are mainly those of compression disorders. We describe a 7cm schwannoma of the heel in a 30-year-old man. Ten years earlier a schwannoma was removed from the same site. The recurrent lesion was widely excised and a medial plantar flap was used to repair the heel.     

Juxtadrenal schwannoma

Schwannoma which originated from Schwann cells is a nerve sheath tumour. Schwannomas of the urogenital tract are very rare. We present a case of a juxtadrenal schwannoma in a 66 years old female patient. To date only three juxtadrenal schwannoma cases have been described in the literature.     

Facial nerve schwannomas: different manifestations and outcomes

BACKGROUND: The purpose of this study was to provide data on the different clinical presentations of facial nerve schwannoma, the appropriate planning for the management of schwannoma of various origins, and the predictive outcomes of surgical management. METHODS: A retrospective study was conducted in a tertiary referral hospital. We reviewed 8 consecutive cases of facial nerve schwannoma diagnosed and managed between 1993 and 2001. RESULTS: Facial nerve schwannomas originated in the internal auditory canal (IAC) (2 cases), parotid gland (2 cases), intratemporal portion (3 cases), and stylomastoid foramen (1 case). Tumor of the stylomastoid foramen presented as an intra- and extratemporal mass. The initial presenting symptom of the 8 patients was facial nerve paralysis in 4 patients, hearing loss in 2, facial numbness in 1, and an infra-auricular mass in 1. Facial palsy occurred in 7 patients during the course of the disease. One patient with a mass in the parotid gland did not show facial palsy up to 1 year after presentation of the initial symptom (facial numbness). Facial nerve paralysis was most severe in intratemporal tumors and less severe in parotid tumors. The patients with IAC suffered from hearing loss and intermittent vertigo and showed decreased vestibular function. The patients with intratemporal tumors also complained of hearing loss. The tumors were completely removed by superficial parotidectomy for parotid tumors; the translabyrinthine approach for 1 IAC tumor and 1 intratemporal tumor; the middle fossa approach for the other IAC tumor; the transmastoid approach for mastoid tumors; and the infratemporal fossa approach for intratemporal and extratemporal tumors. End-to-end cable grafts for the facial nerve were performed in 5 out of 8 cases. In 2 cases, the facial nerve was preserved after the resection of the mass. One case showed complete loss of the peripheral branch of the facial nerve. CONCLUSIONS: Facial nerve schwannoma can present in various ways. By examining the site of origin and the presenting symptoms and signs, we were able to diagnose facial nerve schwannoma preoperatively. According to the operative management of the facial nerve, the postoperative outcome of facial function could be estimated. Our finding could be pivotal in the management of the facial nerve schwannoma.