背景:骨内神经鞘瘤(IS)是一种良性周围神经鞘瘤,假定从头或从先前存在的营养管中的神经纤维中产生。ISs并不常见,占源自骨的肿瘤的不到1%。我们在此介绍了2例下颌骨神经鞘瘤-第一例是一名66岁的女性,有4个月的疼痛和压力史,与下颌骨前放射性粘连有关。第二例是无症状的12岁女性,她的下颌骨联合和右后下颌骨具有独立的放射性。所有三个病变的切开活检均显示良性梭形细胞肿瘤,具有神经鞘瘤的组织学特征;肿瘤细胞对S-100具有强烈反应性。患者进行了完整的病灶摘除,并且在十个月和五年没有疾病的迹象,分别。
方法:进行了系统评价以评估诊断特征,治疗,和患者的预后。
结果:共有93例被确定为以下人口统计学结果:女性占主导地位(57%);平均发生年龄为37.3岁(8至77岁);平均大小为3.6厘米;下颌骨受累(37.6%),下颌体和下颌支(18.3%),和前下颌骨(18.3%)。主要临床体征为肿胀(69.9%),最常见的影像学表现是具有明确边界(72%)的射线透过性(94.6%)。
结论:所有病例均行手术治疗,平均随访时间为22.9个月,复发率为5.4。
BACKGROUND: The intraosseous schwannoma (IS) is a benign peripheral nerve sheath tumor postulated to arise de novo or from nerve fibers in preexisting nutrient canals. ISs are uncommon and comprise less than 1% of neoplasms originating in bone. We herein present two cases of mandibular schwannomas-the first case was a 66-year-old female with a four-month history of pain and pressure associated with an anterior mandibular radiolucency, and the second case was an asymptomatic 12-year-old female with separate radiolucencies of her mandibular symphysis and right posterior mandible. Incisional biopsies of all three lesions showed a benign spindle cell neoplasm with histologic features of a schwannoma; the tumor cells were strongly reactive for S-100. The patients underwent complete enucleation of their lesions and are without evidence of disease at ten months and five years, respectively.
METHODS: A systematic
review was undertaken to evaluate the diagnostic features, treatment, and patient outcomes of gnathic schwannomas.
RESULTS: A total of 93 cases were identified with the following demographic findings: predominance in females (57%); average age of occurrence of 37.3 years (8 to 77 years); mean size of 3.6 cm; and involvement of the mandibular body (37.6%), mandibular body and ramus (18.3%), and anterior mandible (18.3%). The predominant clinical sign was swelling (69.9%), and the most common radiographic presentation was a radiolucency (94.6%) with well-defined borders (72%).
CONCLUSIONS: All cases were treated surgically, with an average follow-up interval of 22.9 months and a recurrence rate of 5.4.