腮腺內之神經鞘瘤－病例報告

Intraparotid Neurilemmoma - Case Report

黃彰暉(Chang-Hui Huang) ； 曹唐義(Tang-Yi Tsao) ； 郝治華(Justin Jyh-Hwa Hao)

《中華民國耳鼻喉科醫學雜誌》 34卷5期 (1999/09) Pp. 432-435

https://doi.org/10.6286/1999.34.5.432

摘要

神經鞘瘤是一種生長緩慢之良性神經組織腫瘤，發生於顏面神經，並以腮腺腫瘤為臨床表現者，實屬罕見。除了少數病例有顏面神經麻痺表現外，大多單純以腮腺腫瘤呈現。術前診斷率極低。本病例為1名43歲女性，因左側耳下緩慢增大之腫塊至本院求診，並無發炎或顏面神經麻痺症狀，手術中卻發現腫瘤源自於顏面神經。在保留顏面神經的原則之下，切除腫瘤。病理報告為神經鞘瘤，門診追蹤迄今無復發跡象。

關鍵字

神經鞘瘤 ； 腮腺腫瘤

並列摘要

A neurilemmoma is a benign, slow-growing neoplasm of neuroectodermal origin. Facial nerve neurilemmoma represents a small proportion of those tumors tha have been documented as having a neuroectodermal origin. Additionally neurilemmoma of the facial nerve displaying a parotid mass is an exceedingly rare occurrence. Except for those tumors displaying a progressively enlarged parotid mass, an intraparotid facial nerve neurilem-moma is generally asymptomatic. This compounds the difficulty of establish-ing a correct diagnosis before surgery. A 43-year-old woman was diag-nosed as having a left intraparotid facial nerve neurilemmoma. A superficial parotidectomy was planned, but during surgery we found the mass to be isolated with its origin at the main trunk of the facial nerve. Consequently, we dissected the tumor from the nerve with great care to insure preserva-tion of the facial nerve. The patient was followed up for seven months at the out patient department. No recurrence has been noted up to the time of this writing. In conclusion, preservation of the facial nerve is of vital importance when dealing with these benign lesions. It should be empha-sized, however, that these types of tumors usually go unnoticed. There-fore, it is important that the surgeon be alert to the possibility of a tumor which is inseparable from the nerve. Furthermore, intra-operative confirma-tion of the tumor by frozen biopsy is imperative because facial nerve preservation can be attempted in benign tumors.

並列關鍵字

neurilemmoma ； parotid tumor