Retropharyngeal Schwannoma Excised Through a Transoral Approach: A Case Report

經口切除治療之後咽腔神經鞘瘤－病例報告

謝佳穎(Chia-Ying Hsieh) ； 蕭仲凱(Jong-Kai Hsiao) ； 王成平(Cheng-Ping Wang)

《The Kaohsiung Journal of Medical Sciences》 22卷9期 (2006/09) Pp. 465-469

摘要

後咽腔內容物僅有脂肪及後咽腔淋巴結。源於此部位的原發性腫瘤甚為罕見。超過百分之二十五的神經鞘瘤出現在頭頸部，但源自於後咽腔的神經鞘瘤則非常罕見。本文中我們報告一位罹患左側後咽腔神經鞘瘤的44歲女性，其臨床表現為打鼾及輕微喉嚨異物感。理學檢查顯示左側口咽壁向前突出，而其覆蓋之黏膜則仍完整平滑。核磁共振影像顯示左側後咽腔有一界限明顯且包膜完整的腫瘤。腫瘤在T2-weighted影像顯示強烈訊號強度；在T1-weighted影像中其訊號強度弱，但在打入顯影劑後強度明顯增加。作者採用經口術式切除此一腫瘤。患者術後復原良好且無明顯併發症。病理診斷結果為神經鞘瘤。術後兩年，患者情況良好並且無腫瘤復發。從解剖及生理觀點來看，以經口術式切除局限於後咽腔的神經鞘瘤是個合理的手術選擇。

關鍵字

切除 ； 後咽腔 ； 神經鞘瘤 ； 打鼾

並列摘要

The contents of the retropharyngeal space are limited to fat and retropharyngeal nodes. Primary tumors originating from the retropharyngeal space are rare. More than 25% of schwannomas are found in the head and neck region, and they are rarely found in the retropharyngeal space. Here, we report the case of a 44-year-old woman with a schwannoma confined to the left retropharyngeal space, who presented with snoring and a mild lump in the throat sensation. Physical examination revealed anterior bulging of the left oropharyngeal wall, with intact mucosa. Magnetic resonance imaging showed a well-defined, encapsulated tumor in the left retropharyngeal space with bright signal intensity on T2-weighted images and low signal intensity on T1-weighted images, which was strongly enhanced after gadolinium administration. The tumor was removed through a transoral approach, resulting in a short postoperative recovery time without complications. The pathologic diagnosis was schwannoma. The patient has been well and free of tumor recurrence for 2 years. From anatomic and physiologic viewpoints, excision through a transoral approach is a good choice for a confined retropharyngeal schwannoma.

並列關鍵字

excision ； retropharyngeal space ； schwannoma ； snoring