Intrathoracic Neurilemmoma of the Vagus Nerve: A Report of Two Cases

胸腔內神經瘤並非少見，絕大部份位於後縱膈腔，而胸廓內迷走神經腫瘤則相當稀少，現在我們提出二病例，病患胸部X-光片呈現一均勻軟組織影像於右上前縱膈腔，電腦斷層影像顯示邊緣清楚，密度不均勻且對比劑後顯影不明顯的腫塊，兩者經接受手術切除後證實為右側迷走神經之神經鞘瘤。該類腫瘤可長大壓迫上縱隔膜的組織而造成症狀，其一病患輕微胸痛合併Horner's症候群多年。另外一病患則有慢性乾咳。Horner's症候群不但可能是頸部或上縱膈腔腫瘤手術後的併發症，亦可能是一個原發式腫瘤復發的重要表微。

關鍵字

迷走神經； Horner's症候群；神經鞘瘤；神經源性腫瘤

並列摘要

Although intrathoracic neurogenic tumors are not uncommon, particularly in the posterior mediastinum, very few reports concerning the intrathoracic neurilemmoma arising from the vagus nerve have appeared in the past decades. We report on two cases of intrathoracic neurogenic tumors of the vagus nerve. The chest roentgenograms of these two patients demonstrated a mass in the superior mediastinum. The chest computed tomography scan showed well-defined masses in the right superior mediastinum, with homogeneously low attenuation. The post-contrast image demonstrated a relatively heterogeneous enhancement with smooth capsulation. Both patients received a complete excision, and the pathologic reports of neurilemmoma were identical. The tumors exerted a compressive effect on the surrounding mediastinal structures, resulting in Homer's syndrome and chest pain in the first patient, and chronic non-productive cough in the second. Horner's syndrome is not only associated with postoperative complications, but is also a sign of a recurrent neurogenic tumor.

並列關鍵字

neurilemmoma ； neurogenic tumor ； Horner's syndrome ； vagus nerve

國際替代計量

Intrathoracic Neurilemmoma of the Vagus Nerve: A Report of Two Cases

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