腹膜后神经鞘瘤1例
蒋旭 曹海明 吴冠伟 董壮 马学平 杨学贞
蚌埠医学院第二附属医院泌尿外科,安徽蚌埠 233040
Retroperitoneal schwannoma: a case report
JIANG Xu CAO Haiming WU Guanwei DONG Zhuang MA Xueping YANG Xuezhen
Department of Urology, the Second Affilated Hospital of Bengbu Medical College, Anhui Province, Bengbu 233040, China
摘要 通过对2017年蚌埠医学院第二附属医院1例腹膜后神经鞘瘤的临床资料进行回顾性分析,探讨腹膜后神经鞘瘤的诊断和治疗。在本例报告中,患者因前列腺癌生化复发入院,在复查CT时发现下腔静脉旁占位,但是患者并无特异性临床表现,术前无法明确肿块性质。完善术前准备后对患者行腹腔镜手术切除占位,术后病理证实为神经鞘瘤,患者预后良好,随访1年神经鞘瘤无复发。通过相关文献的学习,我们认为腹膜后神经鞘瘤是一种罕见的肿瘤,此类患者缺乏特异性临床表现及影像学特征,因此在术前不能作出明确诊断。该肿瘤的确诊依赖于术后病理检查。最佳治疗方式为完全手术切除,手术后患者预后良好,目前腹膜后神经鞘瘤复发的报道较少。
关键词 :
腹膜后占位 ,
神经鞘瘤 ,
下腔静脉 ,
腹腔镜
Abstract :The clinical data of one case of retroperitoneal schwannoma in the Second Affiliated Hospital of Bengbu Medical College in 2017 was retrospectively analyzed to explore the diagnosis and treatment of retroperitoneal schwannoma. In this case report, the patient was admitted due to biochemical recurrence of prostate cancer and found para-inferior vena cava space occupying during CT review, but the patient had no specific clinical manifestations and the nature of the mass could not be determined before surgery. After complete preoperative preparation, laparoscopic surgical resection was performed for the patient, and postoperative pathology confirmed that the patient was a schwannoma. The patient had a good prognosis, and there was no recurrence of schwannoma during 1-year follow-up. Through the study of relevant literature, we believe that retroperitoneal schwannoma is a rare tumor, and such patients lack specific clinical manifestations and imaging features, so a definite diagnosis cannot be made before surgery. The diagnosis of this tumor depends on postoperative pathological examination. The best treatment is complete surgical resection, and the prognosis of patients after surgery is good. At present, the recurrence of retroperitoneal schwannoma is rarely reported.
Key words :
Retroperitoneal space occupation
Schwannoma
Inferior vena cava
Laparoscope
基金资助: 安徽省人力资源和社会保障厅留学人员创新项目择优资助计划项目(2016RSL18)。
通讯作者:
杨学贞(1972.6-),男,博士,主任医师,副教授,硕士生导师;研究方向:泌尿系统肿瘤。
作者简介 : 蒋旭(1993.5-),男,蚌埠医学院第二附属医院2018级泌尿外科学专业在读硕士研究生;研究方向:泌尿系统肿瘤。
[1] Xu SY,Sun K,Xie HY,et al. Hemorrhagic,calcified,and ossified benign retroperitoneal schwannoma [J]. Medicine (Baltimore),2016,95(30):e4318.
[2] Chen W,Dang C,Zhu K,et al. Preoperative management of giant retroperitoneal schwannoma:A case report and review of the literature [J]. Oncol Lett,2016,11(6):4030-4034.
[3] 姜勇,汪欣,万远廉,等.原发性腹膜后神经鞘瘤的外科治疗[J].中华普通外科杂志,2011,26(3):222-224.
[4] Fass G,Hossey D,Nyst M,et al. Benign retroperitoneal schwannoma presenting as colitis:a case report [J]. World J Gastroenterol,2007,13(41):5521-5524.
[5] Virseda Rodríguez JA,Donate Moreno MJ,Pastor Navarro H,et al. Primary retroperitoneal tumors:review of our 10-year case series [J]. Arch Esp Urol,2010,63(1):13-22.
[6] Fu H,Lu B. Giant retroperitoneal schwannoma:a case report [J]. Int J Clin Exp Med,2015,8(7):11598-11601.
[7] 周海涛,周志祥,梁建伟,等.53例腹膜后神经鞘瘤的临床诊治分析[J].中华肿瘤杂志,2014,36(11):867-870.
[8] Asakage N. Laparoscopic resection of a retroperitoneal schwannoma [J]. Asian J Endosc Surg,2012,5(1):25-30.
[9] Vijayan SK,Shetty S,Bhat SR,et al. Retroperitoneal Schwannoma:An Atypical Presentation [J]. J Clin Diagn Res,2014, 8(10):22-23.
[10] Zhang SQ,Wu S,Yao K,et al. Retroperitoneal schwannoma mimicking metastatic seminoma:case report and literature review [J]. Chin J Cancer,2013,32(3):149-152.
[11] 曲腾飞,邱法波,韩冰,等.原发性腹膜后神经鞘瘤生物学特点及手术效果分析[J].中国普通外科杂志,2018, 27(2):255-260.
[12] 沈华,周鹤同,于洪波,等.腹膜后神经鞘瘤1例报告并文献复习[J].现代泌尿外科杂志,2009,14(4):265-267.
[13] 刘贵中,王庆杰,孙光,等.原发性腹膜后神经鞘瘤11例报告[J].中华泌尿外科杂志,2014,35(10):749-752.
[14] Zhang L,Gao M,Zhang T,et al. Surgical management of retroperitoneal schwannoma complicated with severe hydronephrosis [J]. Medicine(Baltimore),2018,97(39):e12528.
[15] Ohsawa M,Miguchi M,Yoshimitsu M,et al. Laparoscopic excision of a retroperitoneal schwannoma:A case report [J]. Asian J Endosc Surg,2019,12(2):192-196.
[16] Latino R,Bosco D,Frattallone ME,et al. Unusual presentation of retroperitoneal Schwannoma:case report [J]. G Chir,2017,38(6):295-298.
[17] 张璐芳,李华.腹腔镜手术切除盆腔腹膜后神经鞘瘤2例报告及文献复习[J].中国微创外科杂志,2017,17(6):571-574.
[18] Malekpour F,John MM,Ungsunan P,et al. Is this mass really in adrenal? Retroperitoneal schwannoma [J]. Am Surg,2014,80(8):238-239.
[19] Radojkovic M,Mihailovic D,Stojanovic M,et al. Large retroperitoneal schwannoma:a rare cause of chronic back pain [J]. J Int Med Res,2018,46(8):3404-3410.
[20] Bevilacqua A,D′Amuri FV,Pagnini F,et al. Percutaneous needle biopsy of retroperitoneal lesions:technical developments [J]. Acta Biomed,2019,90(5/S):62-67.
[21] Daneshmand S,Youssefzadeh D,Chamie K,et al. Benign retroperitoneal schwannoma:a case series and review of the literature [J]. Urology,2003,62(6):993-997.
[22] Niebisch S,Staab H,Ullrich S,et al. Retroperitoneal space-occupying lesion with displacement of the inferior vena cava [J]. Int J Surg Case Rep,2019,57:170-174.
[23] Rajkumar JS,Ganesh D,Anirudh JR,et al. Laparoscopic Excision of Retroperitoneal Schwannoma [J]. J Clin Diagn Res,2015,9(11):5-7.
[24] Chou YS,Liu CY,Chang YH,et al. Prognostic factors of primary resected retroperitoneal soft tissue sarcoma:Analysis from a single asian tertiary center and external validation of gronchi′s nomogram [J]. J Surg Oncol,2016, 113(4):355-360.
[25] Nussbaum DP,Rushing CN,Lane WO,et al. Preoperative or postoperative radiotherapy versus surgery alone for retroperitoneal sarcoma:a case-control,propensity score-matched analysis of a nationwide clinical oncology database [J]. Lancet Oncol,2016,17(7):966-975.
[26] Gu L,Liu W,Xu Q,et al. Retroperitoneal schwannoma mimicking hepatic tumor [J]. Chin Med J(Engl),2008, 121(17):1751-1752.
[27] Maruyama T,Sugamoto Y,Miyagishima D,et al. Laparoscopic resection of a retroperitoneal schwannoma located in the hepatic hilus [J]. Surg Case Rep,2015,1(1):18.
[28] Ragu R,Blanchard C,and Meurette G. Robotic excision of large retroperitoneal Schwannoma (with video) [J]. J Visc Surg,2017,154(4):297-299.
[1]
徐畅 陈英 陆玉莲. 达菲林联合腹腔镜术治疗子宫内膜异位症的临床效果 [J]. 中国医药导报, 2019, 16(8): 84-87.
[2]
李江利 龚冠闻 张传灼 张翼. 胰腺炎外科手术的治疗效果及对患者TNF-α、IL-6水平的影响 [J]. 中国医药导报, 2019, 16(4): 88-91.
[3]
孙慧婷 鞠华妹 刘素芬 虞嘉俊 施如霞 陈莉萍▲. 宫腹腔镜联合修复术与宫腔镜定位电切术在治疗子宫切口瘢痕憩室中的效果评价 [J]. 中国医药导报, 2019, 16(36): 96-99.
[4]
陈琴 李宇飞 周娇娇 李华山. 腹腔镜直肠固定术治疗直肠脱垂的选择策略 [J]. 中国医药导报, 2019, 16(35): 19-23.
[5]
韩雷1 李月廷2. I-gel喉罩在腹腔镜联合胆道镜保胆手术中的应用效果 [J]. 中国医药导报, 2019, 16(34): 108-111.
[6]
张亚运 梁宝权▲. 经脐单孔腹腔镜在妇科手术中的诊治进展 [J]. 中国医药导报, 2019, 16(31): 52-55.
[7]
丁亚兰1 吴卫卫2 纪丽伟1. 生育指数评分对子宫内膜异位症腹腔镜术后妊娠方式的预测能效 [J]. 中国医药导报, 2019, 16(29): 88-91.
[8]
王晛1 甄亚男2 王春喜3 宋舟3 王玲的3 徐忠法2. 老年患者腹腔镜辅助下低位直肠癌前切术中保留左结肠动脉的临床研究 [J]. 中国医药导报, 2019, 16(29): 108-111.
[9]
钟柏冰. 宫腹腔镜联合应用治疗不孕不育症患者的效果 [J]. 中国医药导报, 2019, 16(26): 93-95,99.
[10]
廖春艳 郑见宝 樊慧 张红梅 乔莉娜. 集束化干预在预防腹腔镜下肠道疾病手术患者深静脉血栓形成中的作用 [J]. 中国医药导报, 2019, 16(25): 175-178.
[11]
范艳婷1 吴贵云2 白雪1 魏伟1 徐颖怡1▲. 右美托咪定联合罗哌卡因腹横平面阻滞对小儿腹腔镜隐睾固定术术后镇痛效果的影响 [J]. 中国医药导报, 2019, 16(22): 103-106,114.
[12]
闫彩艳 岳根全 孙婷▲. 全程系统化护理对腹腔镜下肾癌根治术患者临床疗效、心理状态及自我管理效能的影响 [J]. 中国医药导报, 2019, 16(20): 172-176.
[13]
赵相坤1 朱杰2 魏岚3▲. 腹腔镜阑尾切除术和开腹阑尾切除术的效果和成本比较 [J]. 中国医药导报, 2019, 16(19): 98-101.
[14]
曹菁芩1 唐巧丽1 蔡聪聪2. 围术期一体化保温模式在腹腔镜下先天性巨结肠手术中的应用 [J]. 中国医药导报, 2019, 16(19): 177-180.
[15]
黄龙昌 张烨 王彤▲. 纳米碳染色定位在结直肠癌手术中应用的研究进展 [J]. 中国医药导报, 2019, 16(18): 34-37.