経過観察を選択した頸部神経原性腫瘍の9例

DOI Web Site Web Site 参考文献4件
  • 戸部 陽太
    神戸市立医療センター中央市民病院頭頸部外科
  • 篠原 尚吾
    神戸市立医療センター中央市民病院頭頸部外科
  • 竹林 慎治
    神戸市立医療センター中央市民病院頭頸部外科
  • 濱口 清海
    神戸市立医療センター中央市民病院頭頸部外科
  • 道田 哲彦
    神戸市立医療センター中央市民病院頭頸部外科
  • 齊田 浩二
    神戸市立医療センター中央市民病院頭頸部外科
  • 水野 敬介
    神戸市立医療センター中央市民病院頭頸部外科

書誌事項

タイトル別名
  • Follow-up of Nine Cases with Cervical Peripheral Nerve Sheath Tumors in the Neck
  • ケイカ カンサツ オ センタク シタ ケイブ シンケイ ゲンセイ シュヨウ ノ 9レイ

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<p>Peripheral nerve sheath tumors (PNSTs) can arise from almost any nerve in the cervix, and these tumors are mostly benign. In clinical practice, diagnosis of PNSTs at the outpatient department is difficult, therefore, surgical excision, including tumor enucleation, is the first-line treatment. However, surgical excision itself can also cause neurological complications by damaging the nerve from which the PNSTs arise. Smouha has proposed a conservative treatment algorithm for schwannomas of the acoustic nerve. However, there are no reports of such an algorithm for cervical PNSTs.</p><p>8 patients suspected by MRI as having cervical PNSTs were followed-up without surgical treatment at our institution between October 1, 2018, and September 30, 2019. Among 23 patients with cervical PNSTs who had finally undergone tumor resection since 2000, only one patient had been initially followed up for more than 12 months. There were 5 females and 4 males, and the average age was 50 years (range, 36–74 years). All of them presented at first with a neck mass, and none showed any neurological manifestations. The median follow-up duration was 30 months (range, 6–224 months). The median estimated tumor volume was 12.1 cm3 (range 5.0–54.9 cm3). In 8 patients, the tumors were located in the parapharyngeal space and suspected as arising from the vagus nerve or the sympathetic trunk, and in the remaining 1 patient, it was suspected as arising from the C5 trunk. The latest MRI showed an increase of the estimated tumor volume in 2 cases (by more than 120% of the volume in the initial image), a stable tumor volume in 5 cases (80%–120%), and a reduction of the tumor volume in 2 cases (<80%). Of the 9 patients, 8 remained asymptomatic. These results, in spite of the limited number of patients, suggest that a wait-and-see approach could be adopted for some patients with suspected cervical PNSTs. A treatment algorithm for cervical PNSTs including conservative management is expected to be established.</p>

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