摘要
目的探讨眼部神经鞘瘤的临床和影像学检查特征、组织病理学改变、治疗及预后。方法回顾性分析1981年1月～2006年12月手术切除并经病理证实为神经鞘瘤的49例患者的病例资料。结果患者的第一主诉主要为突眼和眶周肿块。肿瘤发生的部位:球后肌肉圆锥30例(65.12%),眉弓、眼睑皮下及内外眦皮下9例,眼眶外上方4例、内上方2例、内侧2例、外下方1例,眼球表面1例。CT扫描38例,MRI成像3例。提示眶内实性占位病变,其中6例有囊样变。组织病理学诊断:神经鞘瘤41例,恶性神经鞘瘤8例。术后随访3个月至8年,7例复发,包括5例良性神经鞘瘤和2例恶性神经鞘瘤,其中1例良性神经鞘瘤复发后变为恶性。复发患者再次手术后在随访期间未再复发。结论眼部神经鞘瘤发生部位广泛,部分有囊性变,部分复发病例可恶变,眼科医师应做出正确的诊断及鉴别诊断,手术切除应完整。
Objective The schwannoma is a tumor of nerve sheath.It can be seen in peripheral nerve everywhere in the body.Majority of schwannoma are benign and a few are malignant.Present paper was to investigate the clinical and imaging characteristics,histopathological types,treatment and prognosis of ocular schwannoma.Methods The clinical and pathological data of 49 patients with ocular schwannoma in West China Hospital from January,1981 to December,2006 were retrospectively analyzed.The patients were followed-up for 3 months to 8 years.Results Tumors located retrobulbar cavity in 30 cases,eyebrow bow or sub-palpebra or sub-canthus in 9 cases,lateral and superior to the orbit in 4 cases,medial and superior in 2 cases,medial in 2 cases and lateral and inferior in 1 case and eyeball surface in 1 case.The most common complaints from patients were proptosis and palpable mass.CT or MRI suggested the solid occupied lesion,in which 6 cases associated with cystic change.Histopathological diagnosis included 41 cases of schw annoma and 8 cases of malignant schwannoma.Five cases of benign schwannoma and 2 cases of malignant schwannoma recurred,in which one case of benige schwannoma became malignant.No recurrence was found after the second surgery during the follow-up.Conclusion Ocular schwannoma grow in many locations of eyeball.Part of lesions presented cystic change and some recurrent cases develop into malignant tumor.Ophthalmologists should pay more attentions to the diagnosis and differentiate diagnosis of schwannoma.The lesion should be resected completely.
出处
《眼科研究》
CSCD
北大核心
2008年第8期606-608,共3页
Chinese Ophthalmic Research
关键词
眼眶
诊断
神经鞘瘤
病理学检查
orbit
diagnosis
neurilemoma
pathological examination
