A case of a malignant peripheral nerve sheath tumor on the cheek following trauma

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  • Aijima Reona
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • Mori Keisuke
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • Danjo Atsushi
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University
  • Ohishi Mitsutoshi
    Department of Radiology, Faculty of Medicine, Saga University
  • Egashira Ryoko
    Department of Radiology, Faculty of Medicine, Saga University
  • Yamada Yuichi
    Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Science, Kyushu University
  • Irie Hiroyuki
    Department of Radiology, Faculty of Medicine, Saga University
  • Oda Yoshinao
    Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Science, Kyushu University
  • Aishima Shinichi
    Department of Pathology & Microbiology, Faculty of Medicine, Saga University
  • Yamashita Yoshio
    Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Saga University

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Other Title
  • 外傷を契機に発見された頬部悪性末梢神経鞘腫瘍の1例

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Description

Malignant peripheral nerve sheath tumors （MPNSTs） are sarcomas derived from peripheral nerves and have high rates of local recurrence and metastasis. We report a case of an MPNST on the cheek that was discovered following trauma. A 75-year-old man experienced a fall while riding a bicycle and injured his face. The swelling of his left cheek did not improve, and he was referred to our department. No bone fracture was observed on image-based examination, and the patient was followed up. Magnetic resonance imaging one month after the injury revealed a solid lesion 40×35×25mm in size in the left masseter muscle, and biopsy revealed a malignant spindle cell tumor. The tumor was resected under general anesthesia, and the histopathological diagnosis was MPNST. Local recurrence was observed 4 months after the surgery. Therefore, recurrent tumor resection was performed, and the tumor was found to infiltrate the facial nerve. External irradiation of 66Gy was performed postoperatively. Eighteen months after the surgery, no local recurrence or distant metastasis was observed. For MPNSTs, wide excision with a sufficient safety margin is the first choice for treatment, but functional preservation and esthetic considerations are required in the head and neck region.

Journal

  • Toukeibu Gan

    Toukeibu Gan 47 (4), 388-394, 2021

    Japan Society for Head and Neck Cancer

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