두 개강외 및 척추강외 신경섬유초종 : CT와 MR 소견

김영근 대한영상의학회 1994 대한영상의학회지 Vol.30 No.1

Purpose: Neurilemoma or schwannoma is a benign tumor originating from the Schwann cell of the peripheral nerve sheath. Most frequently this nerve sheath tumor arises in cranial nerves, occasionally in extremity nerves and rarely in tetroperitoneum or mediastinum. We reviewed to determine CT and MR characteristics of extracranial and extraspinal neurilemoma.Materials and Methods: Eleven CT and 4 MR examinations in 12 patients were retrospectively reviewed.Results : Extracranial and extraspinal neurilemoma were demonstrated as well-defined, round or voal, inhomogeneously enhanced masses(l1/12), located In the region of a known nerve ganglia or pathway, orperispinallyl. The densities of the tumors were lower than the adjacent muscles on the pre-enhanced CT scan, and becams more strongly enhanced than the tumors were similar to adjacent muscles on the T1Wl and high signal intensities to that of adjacent muscies on the T2Wl. Gd-enhanced MR shows inhomogeneous peripheral or wall ehancement.Conclusion : The typical location as well as CT and MR imaging characteristics may be helpful in the preoperative diagnosis of the extracranial and extraspinl neurilemoma 목 적: 신경섬유초종은 말단 신경초의 Schwann 세포에서 발생하는 양성종양으로 주로 두 개 및 척수강내, 사지, 종격등 그리고 드물게는 후복막강에서 발생하기도 한다. 이에 저자들은 두 개 및 척수강외에서 발생한 신경섬유초종의 CT 및 MR 소견을 분석하여 그 진단에 도움이 되는 소견을 얻고자 하였다. 대상 및 방법: 병리조직학적으로 확진된 총 12명의 환자에서 11예의 CT와 4예의 MR영상을 얻어 후향적으로 분석하였다. 결 과: 두 개 및 척수강외에서 발생한 신경섬유초종은 비교적 경계가 명확한 원형, 난원형 또는 소엽상의 불균일한 종괴로 신경총, 신경경로 혹은 척추측방에 위치하고, 조영증강 전 CT 및 MR에서 주위근육보다 저밀도(신호강도) 혹은 동등한 밀도(신호강도)로 보이고, 조영증강 후에는 동등한 밀도(신호강도) 혹은 고밀도(신호강동)로 조영증강을 보였다. 결 론: 종괴의 특징적인 위치와 CT 및 MR 소견으로 두 개 및 척수강외에서 발생한 신경섬유초종의 수술 전 진단이 가능할 것으로 생각된다.

주요 신경과의 연결이 없이 발생한 긴손바닥근의 신경초종

박정용,정성노,손원일,권호 대한성형외과학회 2011 Archives of Plastic Surgery Vol.38 No.4

Purpose: Neurilemoma is benign tumor of the nerve sheath which arises from Schwann cells. It is usually formed along the path of a peripheral nerve but is rarely separate from normal nerve fascicles. We experienced a patient with an isolated neurilemoma localized in the palmaris longus tendon with no connection to the major nerve trunk, which was in an unusual location and has never been reported. We report our case with the review of the literature. Methods: A 23-year-old female visited our clinic with mild pain on the mass at the flexor area of the right wrist which had been present for about one year. The physical examination revealed a 1 × 1 cm sized subcutaneous mass at the flexor area of the right wrist. Sonography and computed tomography showed an ovoid, superficial solid mass on the palmaris longus tendon. Upon surgical excision, a 1 × 0.5 cm sized mass attached to the palmaris longus tendon was found. The tumor had no connection with the median nerve and was detached easily from the palmaris longus tendon. Results: Histological examination demonstrated the mass to be a neurilemoma, which consists of spindle shaped cells with oval elongated nuclei arranged fascicles. No sensory dysfunction or evidence of recurrence was found during the 12 months of postoperative follow-up. Conclusion: We experienced a rare case of neurilemoma attached to the palmaris longus tendon with no connection to the major nerve trunk. We wish to emphasize its unusual location through our case and hope to expand our spectrum in exploring the upper extremity mass.

상완신경총의 신경초종

최종욱,김용환,이승훈,이은수,최건 한국의학사 1997 診斷과治療 Vol.17 No.9

비첨부에 발생한 신경초종의 미용적 치험례

문주봉,이근철,나서희,박정민,김석권,하재성 대한미용성형외과학회 2005 Archives of Aesthetic Plastic Surgery Vol.11 No.2

Neurilemoma(schwannoma, neurinoma, Schwann's cell tumor) is a relatively uncommon, slowly growing lesion that usually has been present for a considerable time before diagnosis and treatment are requested. The site of origin is believed to be the ectodermal Schwann cells of the nerve sheath. An interesting variant, known as the ancient neurilemoma, has been reported by Eversole and others. They suggest that the histologic feature that typify this tumor result from degenerative changes which occur as a classic neurilemoma ages. We have experienced a case of schwannoma arising on the nasal tip of a 27 years old man and discussed with brief current literatures review.

사지 말초신경에 발생한 신경초종의 수술적 치료

편영식,김성렬,조영록,Pyun, Young-Sik,Kim, Seong-Ryeol,Joh, Young-Rok 대한근골격종양학회 1998 대한골관절종양학회지 Vol.4 No.2

Neurilemoma usually discovered incidentally, is a benign nerve-sheath tumor which has been described as a painless mass. In most cases, the size of the mass was smaller than 5cm. However, it was reported that there were masses, sometimes associated with local tenderness and pain, whose size was over 6cm. Then, we have found there is a relationship between mass size and neurologic symptoms, as well as with, postoperative complications. It is important to diagnose early and to treat it. Twenty neurilemoma patients, who were treated at Keimyung University Dongsan Medical Center were analyzed using their clinical symptoms, pathologic findings, radiologic findings and complications. There was no sexual difference in tumor incidence. The anatomical locations of tumors were as follows. ; upper extremities in 15 cases(69%), axilla in 1 case(4%) and lower extremities in 6 cases(27%). Symptoms were palpable mass in 22 cases, local tenderness in 8 cases(36%), radiating pain in 6 cases(27%) and paresthesia in 6 cases(27%), Median nerve was involved most frequently(33%). There were 2 patients(10%) with multiple symptoms. Tumor enucleation was done in all cases. The size of tumors in longest axis was smaller than 2cm in 2 cases, between 2 and 4cm in 11 cases and more than 5cm in 9 cases. There was no case of malignant transformation or recurrence. In conclusion, incidence of clinical symptom and postoperative complications are increased with the size of the tumor especially over the 5cm. Preoperative MRI finding was the most accurate method of diagnosis and most helpful in determining surgical resection margin.

S-100 염색으로 진단한 비강내 신경초종 1예

류찬,김수환,박찬순,조광재 대한이비인후과학회 2002 대한이비인후과학회지 두경부외과학 Vol.45 No.4

Neurilmoma is a benign tumor which originate from the neuroectodermal Schwann cell of cranial, intraspinal, peripheral accounting for 25% to 45% of all cases, has been reported in the head and neck area. Except the acoustic neurilemoma which is the most comon in the otolaryngologic fields, neurilemoma originating from the nasal cavity and paranasal sinus is very rare (about 4%). Recently, the authors have experienced a case of neurilemmoma of nasal cavity and thus presents the clinical and radiolographic findings along with a review of the literature. (Korean J Otolaryngol 2002;45:412-5)

기관폐쇄를 동반한 기관 신경초종 환자에 있어 레이져를 이용한 부분절제술후 기관절제술의 경험

박성민,김광택 대한흉부심장혈관외과학회 1999 Journal of Chest Surgery (J Chest Surg) Vol.32 No.10

Tracheal neurilemoma, an extremely rare benign tracheal tumor that there has been only one case reported in 1996 throughout the nation, is a slowly progressing disease that obliterates the upper airway, delays diagnosis for its symptom similarity to asthma, and makes intubation for operation difficult. Bronchoscopic is therefore needed for diagnosis. There are two options for the treatment methods, a bronchoscopic resection or open surgical resection; however if intubation is difficult, then the bronchoscopic resection is used first to keep the airway open for the surgical resection. In this case, the severe tracheal stenosis impeding intubation made the surgical resection of the primary tracheal neurilemoma with extratracheal mass impossible; therefore, bronchoscopic laser resection was applied first to optain the airway passage for endotracheal intubation, followed by a successful open surgical resection.

사지에 발생한 신경 초종의 임상 분석 : 다발성 병변 2례 포함 Include 2 Cases of Multiplicity

박찬희,안철세 충남대학교 의과대학 지역사회의학연구소 1994 충남의대잡지 Vol.21 No.2

Neurilemoma is the most common tumor arising from peripheral nerves. Neurilemomas arise from a benign proliferation of Schwann cells usually as a single lesion and rarely disturb the function of involved nerve. The tumors are well encapsulated and may be easily enucleated from the parent nerve. Resection of involved nerve is seldom necessary except when small nerves are extensively involved. We reviewed our 7 experiences and found out that multiplicity is not rare (two in seven cases) and sometimes there was a symtpoms of pain, tenderness, paresthesia.

신경초종의 임상적 분석

서진수,김병직,고한석,서정국,주석규,김진구,강영훈 인제대학교 1998 仁濟醫學 Vol.19 No.2

신경초종은 신경초에 발생하는 드문 양성 종양이나, 말초신경 기원의 종양으로는 많은 부분을 차지한다. 본 연구의 경우, 주 증상으로는 종괴를 우연히 발견하여 내원한 경우가 가장 많았고, 동통, Tinel sign, 운동 혹은 감각 이상, 방사통, 저린감으로 다양하게 나타났다. 평균연령 55.4세, 남녀비 7:10으로 나타났다. 호발 신경은 척골신경, 좌골신경, 후경골신경 순이었다. 세침 흡인 검사상 방추형 세포가 나타나 진단적 가치가 높았다. 수술은 대개 적출술을 시행하여 수술 후 증상의 소실을 보였고, 6예에서 합병증을 가졌으나 추시중 합병증의 소실을 보였다. Neurilemoma which cccurres in nerve sheath, is a rare benign tumor, but it largely occupies in the origin of peripheral nerve. In the case of this study, mass is accidentally discovered in the main symptom, and pain, tined sign. motor weakness, sensory change, radiating pain and tingling sensation were appeared as symptom in variety. The average age is 55.4 and the ratio of man to woman is 7:10. Origin nerve is ulna nerve in first, sciatic nerve is second. And posterior tibial nerve is third. In the test of aspiration cytology, spindle cell is appeared and it is highly valued in the aspect of diagnosis. The operation is mostly carried into effect as enucleation. After that, the symptom fades away. The complication is developed in six cases, but it disappeared in follow up

골반강에 발생한 신경초종 1례

윤희철,정치영,전상준,박경민,박희수,노준,김철성,장대수 大韓泌尿器科學會 2000 Korean Journal of Urology Vol.41 No.7