惡性神經鞘瘤(Malignant Schwannoma)－一個案報告及文獻回顧

Malignant Schwannoma-A Case Report and Review of the Literature

鄭天宇(Tian-Yeu Jeng) ； 王先震(Hsien-Jenn Wang)

《中華民國重建整形外科醫學會雜誌》 2卷1期 (1993/03) Pp. 42-45

https://doi.org/10.7096/JPRSA.199303.0042

摘要

惡性神經鞘瘤(Malignant Schwannoma)是一種少見的神經鞘細胞瘤，它是由鞘細胞(Schwann cell)衍生而來，平均好發年齡為 30~50 歲，男女大致相等。以四肢部位較常見，軀幹及頭 、頸部次之。臨床表現為無痛性突出腫塊，僅少數(9%)病人有疼痛症狀。診斷主要靠組織病理切片檢查並輔以免疫組織化學研究如S-100蛋白質及Vimentin呈陽性反應。治療則以徹底切除手術，甚至截肢為最佳方式。平約5年之存活率有50%，單獨使用放射線治療或化學藥物治療，則有待進一步的研究與評估。本文報告一手部惡性神經鞘瘤，因屬罕見腫瘤，故加以提出，並參考文獻加以討論。

並列摘要

Malignant schwannornas are rare tumors of nerve sheath which was considered arising from schwann cells. It occurred more common between 30-50 years of age. There is no ignificant sex predilection. It usually arised in the extremities, Iess commonly in the trunk, head and neck. The rnajority of patients were seen because of the presence of a mass, only 9% of them had experienced pain. The djagnosis of malignant schwannoma was estab1ished histological and supplementary with immunohistochemic1 study which showed S-100 protein and vimentin were positive. Radlcal excision 15 the best cholce for controlling the tumor. The averages 5-year survival rate was 50%. Radiation therapy alone or chemotherapy to the tumor is inconclusive. This paper reports a rare case of malignant schwannorna over the right hand and wrist. The 11terature was reviewed and discussed.