舌癌患者疑似淋巴結腫大之頸部許旺細胞瘤－病例報告

許旺細胞瘤是一種良性、緩慢生長、有包膜的神經鞘瘤，由許旺細胞組成，可源於身體的任何腦神經、周邊神經或自主神經。約25%－45%的許旺細胞瘤源於頭頸部區域，一般無症狀，影像評估通常不具特異性，因此術前診斷困難，治療的首選方式為手術切除，需透過病理組織學檢查而得最終診斷。本病例為61歲男性，因舌頭潰瘍而就診，經切片確診為舌癌，且正子斷層掃描影像顯示左頸部第二區有氟化去氧葡萄糖攝取增強之病灶，疑似淋巴結轉移。病患接受手術治療，術中針對左頸部病灶送冷凍切片檢查，結果意外發現為許旺細胞瘤。透過相關文獻回顧，對許旺細胞瘤臨床症狀、影像學及病理學特徵、治療方式等整理，並強調許旺細胞瘤和病理性淋巴結鑑別診斷的臨床重要性。

關鍵字

許旺細胞瘤；淋巴結腫大；口腔癌；頭頸部

並列摘要

Schwannoma is a benign, slow-growing, well-encapsulated tumor composed of Schwann cells that can arise from any cranial, peripheral, or autonomic nerves in the body. About 25%-45% of Schwannomas originates from the head and neck region. They are generally asymptomatic, and imaging evaluation is usually non-specific, so preoperative diagnosis is difficult. The preferred method for the treatment is surgical resection. The final diagnosis is made by the histopathology. This is a rare case, because it involved a Schwannoma mimicking cervical lymphadenopathy. A 61-year-old male was diagnosed with tongue squamous cell carcinoma, and the PET/CT demonstrated high FDG uptake in the primary lesion and in the level II of left neck, which suggested metastasis. The patient underwent surgical treatment, and intraoperative frozen section consultation was conducted for the suspected lymph node metastasis. It was unexpectedly found to be Schwannoma. Therefore, we review papers about the clinical symptoms, imaging and pathological features, treatments of Schwannoma, and the clinical importance of differentiating schwannomas from pathologic lymph nodes was emphasized.

並列關鍵字

Schwannoma ； Lymphadenopathy ； Oral cancer ； Head and neck

主題瀏覽