atypical presentation

非典型演示
  • 文章类型: Case Reports
    2型神经纤维瘤病(NF2)是一种罕见的遗传性疾病,涉及中枢神经系统和周围神经系统的多个肿瘤。大多数NF2患者患有双侧前庭神经鞘瘤;非前庭神经鞘瘤也可能发生。虽然大多数患者可能存在听力障碍,耳鸣,头晕和平衡障碍,有些可能出现皮肤表现。我们描述了一名20岁男子的病例,该男子最初在左耳前区域出现了一个孤立的皮下无痛结节,没有任何其他症状。他接受了耳前肿块的切除活检,病理诊断为神经鞘瘤。脑和颈部的磁共振成像显示双侧桥小脑角池上有多个肿块,延伸到双侧内耳道,双侧颈神经孔,颈椎和上胸椎管,和左后颈。患者根据临床标准诊断为NF2。他接受了伽玛刀立体定向放射外科治疗双侧前庭神经鞘瘤,目前正在定期监测。结论:NF2患者可能存在孤立性皮肤神经鞘瘤,没有其他相关临床表现。因此,尽管没有其他临床发现,但仍有必要对患有外周神经鞘瘤的年轻患者进行进一步评估。
    Neurofibromatosis type 2 (NF2) is a rare genetic disease involving multiple tumors of the central and peripheral nervous systems. Most patients with NF2 have bilateral vestibular schwannomas; nonvestibular schwannomas may also develop. While the majority of patients may present with hearing impairment, tinnitus, dizziness and balance disorders, some may present with cutaneous manifestations. We describe the case of a 20-year-old man who initially presented with a solitary subcutaneous painless nodule in the left preauricular area without any other symptoms. He received excisional biopsy for the preauricular mass and the pathologic diagnosis was schwannoma. Magnetic resonance imaging of brain and neck revealed multiple mass lesions over the bilateral cerebellopontine angle cisterns, extending to the bilateral internal auditory canals, bilateral cervical neuroforamens, cervical and upper thoracic spinal canals, and left posterior neck. The patient was diagnosed with NF2 according to the clinical criteria. He underwent gamma knife stereotactic radiosurgery for bilateral vestibular schwannomas and is now under regular monitoring. CONCLUSION: NF2 patients may present with an isolated solitary cutaneous schwannoma with no other associated clinical findings. Further assessment is thus warranted in young patients presenting with a peripheral schwannoma despite absence of other clinical findings.
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