神經鞘瘤約有25~45%會出現在頭頭部。出現在鼻腔的不到4%,而出現在鼻尖的更是少見,回顧文獻報告僅有3例。在此報告另一例鼻尖部神經鞘瘤。患者為一名15歲男孩,在鼻尖部長了一個3×2cm的腫瘤,除漸有鼻塞外,沒有其它任何症狀,包括鼻出血、流膿、疼痛箏,經手術切除後,病理診斷為神經鞘瘤。 鼻尖的腫瘤會妨礙外觀的表現,尤其是手術處理不當時更會造成外觀上的缺陷,所以術前的診斷與術式的仔細評估是很重要的,在診斷上必須要區別的有惡性腫瘤、轉移腫瘤、發育畸型、以及發炎箏,而當病人在鼻尖部出現具有彈性腫瘤時,神經鞘瘤就應列入考慮。此時簡單的經由鼻內切除即可達到治療效果。 本文除了病例報告外亦同時回顧文獻,在臨床症狀、X光片的發現、組織學上的特點、區別診斷及治療方面做了整理與報告,讓讀者對此一鼻部罕見疾病能有更深入的了解。
Schwannomas are rarely found in the sinonasal tract, localization at the nasal tip is exceedingly rare. A 15-year-old male presented with a 3×2-cm nasal tip mass. The tumor was completely removed through endonasal excision, and the diagnosis of a schwannoma was confirmed. Nasal tip tumors can cause cosmetic deformity. A correct diagnosis of the nature of the tumor is important to decide on a suitable protocol for therapy. The differential diagnosis should include benign neoplasms, malignant neoplasms, metastatic tumors, developmental anomalies and inflammation. When a sharply elastic delineated mass at the nasal tip without specific nasal symptoms is encountered, it should be kept in mind that a schwannoma may be the origin of the tumor. The literatures were reviewed, and the characteristics of the rare case were discussed.
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