Cellular schwannoma

  • 文章类型: Journal Article
    背景:细胞神经鞘瘤(CS)是一种罕见的肿瘤,占所有良性神经鞘瘤的2.8-5.2%。文献中缺乏关于脊柱CS的最新信息。
    目的:本研究的目的是确定脊柱良性神经鞘瘤中CS病例的比例,描述脊柱CS的临床特征,并通过分析93例连续CS病例的数据确定局部复发的预后因素。
    方法:回顾性回顾。
    方法:我们分析了2008年至2021年间在我们研究所接受治疗的1706例脊柱CS患者中筛查的93例PSGCT。
    方法:人口统计学,射线照相,记录和分析手术和术后数据.
    方法:我们比较了颈椎脊髓CS的临床特征,胸廓,腰椎和骶骨段。通过Kaplan-Meier方法确定无局部复发生存期(RFS)的预后因素。单因素分析中p≤0.05的因素采用Cox回归分析进行多因素分析。
    结果:所有良性神经鞘瘤中脊柱CS的比例为6.7%。本研究中93例患者的平均和中位随访时间分别为92.2和91.0个月(范围为36至182个月)。11例局部复发,总复发率为11.7%,一个病人死亡。统计分析显示肿瘤大小≥5cm,病灶内切除,Ki-67≥5%是脊柱CSRFS的独立阴性预后因素。
    结论:只要有可能,脊柱CS建议整块切除。肿瘤大小≥5cm且术后病理Ki-67≥5%的患者应进行长期随访。
    BACKGROUND: Cellular schwannoma (CS) is a rare tumor that accounts for 2.8%-5.2% of all benign schwannomas. There is a dearth of up-to-date information on spinal CS in the literature.
    OBJECTIVE: The aims of this study were to identify the proportion of CS cases amongst spinal benign schwannoma, describe the clinical features of spinal CS, and identify prognostic factors for local recurrence by analyzing data from 93 consecutive CS cases.
    METHODS: Retrospective review.
    METHODS: We analyzed 93 PSGCT screened from 1,706 patients with spine CS who were treated at our institute between 2008 and 2021.
    METHODS: Demographic, radiographic, operative and postoperative data were recorded and analyzed.
    METHODS: We compared the clinical features of spinal CS from the cervical, thoracic, lumbar and sacral segments. Prognostic factors for local recurrence-free survival (RFS) were identified by the Kaplan-Meier method. Factors with p≤.05 in univariate analysis were subjected to multivariate analysis by Cox regression analysis.
    RESULTS: The proportion of spinal CS in all benign schwannomas was 6.7%. The mean and median follow-up times for the 93 patients in this study were 92.2 and 91.0 months respectively (range 36-182 months). Local recurrence was detected in 11 cases, giving an overall recurrence rate of 11.7%, with one patient death. Statistical analysis revealed that tumor size ≥5 cm, intralesional resection, and Ki-67 ≥5% were independent negative prognostic factors for RFS in spinal CS.
    CONCLUSIONS: Whenever possible, en bloc resection is recommended for spinal CS. Long-term follow-up should be carried out for patients with tumor size ≥5 cm and postoperative pathological Ki-67 ≥5%.
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  • 文章类型: Journal Article
    目的:探讨病理变化的差异,放射学,细胞性神经鞘瘤(CS)和非细胞性神经鞘瘤(NCS)的预后特征。
    方法:对24例CSs和30例NCSs的CT和MRI图像进行回顾性分析。CSs和NCSs的临床病理特征和肿瘤放射学特征,包括位置,形状,尺寸,边界,囊性固体成分,出血,钙化,骨重塑,CT/MRI造影前扫描模式,增强程度,目标标志,并记录肿瘤血管。统计分析采用卡方检验或Fisher精确检验,独立样本t检验,和logistic回归分析比较CSs和NCSs之间的差异。
    结果:四个CSs显示有丝分裂活性,在NCS组中未发现(P=0.034)。CS组MIB-1指数高于NCS组(P=0.002)。2例CS患者出现肿瘤复发。与NCS相比,CSs通常位于脊柱区(P=0.028)和不规则(P=0.013),较大(P=0.005)。目标标志,NCSs中的一个常见发现(7/22,31.8%),在CSs中未见到(P=0.014)。肿瘤血管仅见于CS组(4/22,18.2%;P=0.027)。回归分析显示,位置(P=0.048)和大小(P=0.012)是区分CSs和NCSs的独立指标。
    结论:CS是一种罕见的神经鞘瘤亚型,具有一些重要的放射学特征,包括对脊柱区域的偏爱,不规则形状,大肿瘤大小,缺少目标信号,肿瘤血管,和潜在的复发风险。神经鞘瘤的位置和大小是区分CSs和NCSs的最有用指标。
    OBJECTIVE: To investigate the differences of pathological, radiological, and prognostic features between cellular schwannoma (CS) and non-cellular schwannoma (NCS).
    METHODS: CT and MRI images of 24 patients with CSs and 30 patients with NCSs were reviewed retrospectively. Clinico-pathological characteristics of CSs and NCSs and tumor radiological features including location, shape, size, border, cystic-solid components, hemorrhage, calcification, bone remodeling, pattern of CT/MRI precontrast scan, degree of enhancement, target sign, and tumor vessels were recorded. Statistical analyses were performed with Chi square or Fisher\'s exact test, independent sample t test, and logistic regression analysis to compare the differences between CSs and NCSs.
    RESULTS: Four CSs showed mitotic activity, which was not found in the NCS group (P = 0.034). The CS group showed higher MIB-1 index than that in the NCS group (P = 0.002). Two patients with CS presented with tumor recurrence. Compared to NCSs, CSs were often located in spinal area (P = 0.028) and irregular (P = 0.013) with larger size (P = 0.005). Target sign, a common finding in NCSs (7/22, 31.8 %), was not seen in CSs (P = 0.014). The tumor vessels were only seen in CS group (4/22, 18.2 %; P = 0.027). Regression analysis revealed that location (P = 0.048) and size (P = 0.012) were independent indicators in differentiating CSs from NCSs.
    CONCLUSIONS: CS is a rare subtype of schwannoma with some significant radiological features including a predilection for the spinal area, irregular shape, large tumor size, absent target sign, tumor vessels, and potential risk of recurrence. Location and size of the schwannomas were the most useful indicators in differentiating CSs from NCSs.
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  • 文章类型: Comparative Study
    BACKGROUND: Malignant peripheral nerve sheath tumors (MPNSTs) and cellular schwannomas (CSs) of the eighth cranial nerve are exceedingly rare. The purpose of the present study was to evaluate clinical and genetic characterization of these rare tumors.
    METHODS: The clinical and radiological features were analyzed retrospectively. The histopathological characteristics were assessed by hematoxylin and eosin staining and immunohistochemistry. Genomic abnormalities were evaluated using array comparative genomic hybridization.
    RESULTS: Of the 1287 surgeries for vestibular schwannomas from 2014 to 2017, 2 were for MPNSTs and 5 were for CSs. The mean age at diagnosis was older for patients with MPNSTs (57.0 ± 4.2 years) than that of patients with CS (35.8 ± 9.4 years; P = 0.03). Two patients with MPNST died of tumor recurrence. None of the patients with CS died. The 2-year overall and progression-free survival of patients with MPNSTs were worse than those for patients with CSs (overall survival, 50.0% ± 35.4% vs. 100%, P = 0.027; progression-free survival, 0% vs. 100%; P = 0.012). The Ki-67 index for the MPNSTs (29.0% ± 3.5%) was greater than that for the CSs (10.3% ± 3.1%; P = 0.001). The common alterations in MPNSTs mainly included gains of chromosomes 7p, 8p, 9q, 12, and 17 and loss of heterozygosity of 1p, 6 and 9p. The common alterations in CSs included gain of 4p16.3, loss of heterozygosity of 2p15-14, and 22q11.1-13.3.
    CONCLUSIONS: To the best of our knowledge, the present study is the first high-resolution genomic analysis of MPNSTs and CSs of the eighth cranial nerve and has shown a significant difference that might be more accurate to distinguish between these 2 types of rare tumors.
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  • 文章类型: Case Reports
    Cellular schwannoma, an unusual histological subtype of schwannoma, is a benign hypercellular variant of a peripheral nerve sheath tumor. We report a 48-year-old woman with sudden onset of paraplegia. The complete surgical resection was achieved. This is the first report about intraspinal canal cellular schwannoma following spontaneous acute hemorrhage and paraplegia.
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