背景:颈侧块管理经常挑战外科医生。神经组织肿瘤是此类结节的罕见原因。神经源性肿瘤占头颈部肿瘤病变的一小部分。考虑到这个区域的神经数量,令人惊讶的是,这种肿瘤并不常见。
方法:对所有到开罗国家癌症研究所就诊的患者进行了回顾性研究,埃及,头颈部神经源性肿瘤。
结果:在埃及国家癌症研究所(2006-2015)的过去10年中,方法对40例头颈部神经源性肿瘤进行头颈部单元治疗。患者年龄为2至78岁,平均年龄为34.7岁。在这项研究中,儿童神经源性肿瘤仅占9例(22.5%)。诊断为这些肿瘤的男性患者包括16例,而女性患者包括24例,男女比例为1.5:1。患者的表现取决于肿瘤的生物学行为;例如,其中一些表现为缓慢增长的无痛性界限清楚的活动肿胀,和其他人表现为迅速增长的肿胀与神经缺陷。临床图片和影像学研究,如CT和MRI引起怀疑,可能有助于描绘此类肿瘤,但明确的诊断是通过组织活检获得的.手术是大多数头颈部神经源性肿瘤的主要治疗手段,而辅助治疗在某些类型的神经源性肿瘤中获益有限。恶性组的5年生存率为60%,而15例中有6例(40%)报告死亡。结论:大多数神经源性头颈部肿瘤是良性的。准确的术前评估和高度怀疑是管理的第一步。适当的治疗包括完整的手术切除;然而,除权程序具有重要作用。恶性神经源性肿瘤具有侵袭性,可通过根治性手术切除和放射疗法联合治疗。局部晚期不可切除或转移性疾病可尝试化疗。
BACKGROUND: Lateral neck mass management frequently challenges surgeons. Nerve tissue neoplasms are an uncommon cause of such nodules. Neurogenic tumors form a tiny percentage of the head and neck neoplastic lesions. Considering the number of nerves in this area, it is surprising that such neoplasms are not more frequently seen.
METHODS: A retrospective study was conducted on all patients who presented to the National Cancer Institute of Cairo, Egypt, with head and neck neurogenic neoplasms.
RESULTS: During the last 10 years at the National Cancer Institute of Egypt (2006-2015), 40 cases of neurogenic tumors of the head and neck were treated at the head and neck unit. Patients\' ages ranged from two to 78 years with a mean age of 34.7 years. Childhood neurogenic tumors accounted for nine cases (22.5%) only in this study. Male patients diagnosed with these tumors comprised 16 cases, while female patients comprised 24 cases, with a female-to-male ratio of 1.5:1. Patient presentation depends on the biological behavior of the tumor; for instance, some of them present by slowly growing painless well-circumscribed mobile swelling, and others present by rapidly growing swelling with neurological deficit. Clinical picture and imaging studies such as CT and MRI raise suspicion and may help delineate such tumors, but a definitive diagnosis is obtained by tissue biopsy. Surgery is the mainstay of treatment in most head and neck neurogenic tumors, whereas adjuvant therapy is of limited benefit in some types of neurogenic tumors. The five-year survival rate was 60% for the malignant group, while death was reported in six out of 15 cases (40%). Conclusion: Most neurogenic head and neck tumors are benign. Accurate preoperative assessment and a high degree of suspicion are the initial steps in the management. Proper treatment involves complete surgical excision; however, debulking procedures have an important role. Malignant neurogenic tumors are aggressive and are treated with combined radical surgical resection and radiation. Chemotherapy is tried for locally advanced unresectable or metastatic disease.