Schwannoma of the Nasal Septum-Case Report

鼻中隔神經鞘瘤－病例報告

黃朝欽(Chao-Chin Huang) ； 鄭評嘉(Ping-Chia Cheng) ； 鄭博文(Po-Wen Cheng) ； 廖立人(Li-Jen Liao)

《台灣耳鼻喉頭頸外科雜誌》 56卷2期 (2021/06) Pp. 119-123

https://doi.org/10.6286/jtohns.202106_56(2).119

摘要

Schwannoma is the most common nerve sheath tumor, and it is composed of Schwann cells. However, nasal septal schwannomas are rare, with only 34 benign cases reported in the literature. We reported the case of a 63-year-old man who had a right nasal obstruction for more than 1 year. The patient denied symptoms of epistaxis, smelling a foul odor, anosmia, headache, or a history of nasal trauma. Anterior rhinoscopy revealed a tumor on the right nasal septum with a wide-based attachment, sized 1.5 × 1 × 1 cm. Excision with the assistance of a nasal speculum under general anesthesia was performed. Histopathology showed spindle cells with alternating hypercellular areas (Antoni A area), hypocellular areas (Antoni B area) and focal nuclear palisading (Verocay body). Immunohistochemistry revealed that the tumor cells were diffusely positive for S-100 and negative for CD34. Pathology confirmed the diagnosis of schwannoma. There was no recurrence during the follow-up period of one year.

關鍵字

nasal septum ； schwannoma

並列摘要

神經鞘瘤是最常見的神經髓鞘腫瘤，由許旺細胞組成。鼻腔鼻竇神經鞘瘤僅佔頭頸部神經鞘瘤的4％。然而，鼻中隔神經鞘瘤極為罕見，回顧文獻僅有34例良性病例。我們報告1例63歲男性，右側鼻塞超過1年的症狀。患者否認有鼻出血、鼻腔惡臭、嗅覺減退或頭痛等症狀及鼻外傷史。前鼻鏡檢查顯示右側鼻腔有一鼻中隔腫瘤，尺寸為1.5 × 1 × 1 cm。病患在全身麻醉下藉由前鼻鏡輔助接受腫瘤切除手術。組織病理學顯示梭形細胞（spindle cells）伴隨有交替的高細胞區域（Antoni A）、低細胞區域（Antoni B）和局部核柵欄（Verocay body）。免疫組織染色顯示腫瘤細胞對S-100呈瀰漫性陽性反應，對CD34呈陰性反應。病理報告證實神經鞘瘤的診斷。本病例追蹤1年後並無復發。

並列關鍵字

nasal septum ； schwannoma（鼻中隔 ； 神經鞘瘤）