Neurilemoma of the Tongue: the Diagnostic Dilemma in a Case

舌部神經鞘瘤之困難診斷－病例報告

李立慈(Li-Tzu Lee) ； 關寶祥(Po-Cheung Kwan) ； 黃穰基(Yong-Kie Wong)

《中華民國口腔顎面外科學會雜誌》 15卷2期 (2004/09) Pp. 141-150

https://doi.org/10.7104/CJOMS.200409.0141

摘要

神經鞘瘤是一種神經上皮瘤(neuroectodermal tumor)源自Schwann細胞。此細胞是構成神經束外層之細胞，神經鞘瘤是生長緩慢之腫瘤，可發生在任何年齡層，常在20-30歲發現，患者除了腫瘤壓迫到神經造成疼痛及異常的感覺外，其他多無症狀。據統計，神經鞘瘤有1/3出現於頭頸部。神經鞘瘤可以MRI影像作為主要之診斷工具，手術切除為最好之治療方法，若全部切除復發率低且不容易轉為惡性腫瘤。本篇的目的是報告如何診斷較困難的舌部神經鞘瘤。患者在手術前被誤診為血管瘤，在術後其病理報告是神經鞘瘤，藉由回溯病史與MRI的影像分析，提供鑑別診斷經驗，以作為爾後相似病例之參考。

關鍵字

神經鞘瘤 ； 舌部 ； MRI

並列摘要

Neurilemoma, also termed Schwannoma, is a benign tumor of Schwann cell origin. This neoplasm can occur at any location in the oral cavity and is usually asymptomatic. MRI is an excellent tool for diagnosis. Treatment is by surgical excision and malignant change is rare. We report a case of a young female who was admitted with a swelling in the anterior portion of the tongue. The mass was light purple in color and became larger when the patient flexed her neck. MRI showed a uniformly round or oval mass with a moderately bright signal on Ti-weighted image and a bright heterogeneous signal on T2-weighted image. Under the impression of hemangioma, angiography was performed. The tumor was excised and histopathologic examination showed a typical neurilemoma with dilated blood vessels and organizing thrombi. The patient recorvered well after surgery with complete and rapid relief of symptoms. No recurrence was noted at one-year follow-up.

並列關鍵字

Neurilemoma ； MRI ； Tongue