Management of Malignant Schwannoma with Infratemporal Fossa Extension

被引:0
作者
Ghindea, Teodora Ioana [1 ]
Zainea, Viorel [1 ,2 ]
Ionita, Irina-Gabriela [1 ]
Carazanu, Teofana [3 ]
Meius, Alexandru-Dumitras [1 ]
Pietrosanu, Catalina [1 ]
Pulpa, Raluca [1 ]
Radoi, Gigi-Silviu [1 ]
Hainarosie, Mura [2 ]
Panea, Cristina [4 ]
Hainarosie, Razvan [1 ,2 ]
机构
[1] Carol Davila Univ Med & Pharm, 8th Eroii Sanit, Bucharest, Romania
[2] Prof Dr D Hociota Inst Phonoaudiol & Funct ENT Su, 21st Mihail Cioranu St, Bucharest, Romania
[3] Prof Dr Alexandru Obregia Psychiat Hosp, 10th Berceni Rd, Bucharest, Romania
[4] Elias Univ Clin Hosp, 17th Marasti Blvd, Bucharest, Romania
来源
NATIONAL ENT, HEAD AND NECK SURGERY CONFERENCE | 2017年
关键词
malignant schwannoma; infratemporal fossa; NERVE SHEATH TUMORS; TRANSMANDIBULAR TRANSPTERYGOID APPROACH; PROGNOSTIC-FACTORS; SKULL BASE; HEAD; NECK;
D O I
暂无
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Introduction Malignant Schwannoma also known as neurofibrosarcoma or MPNST (malignant peripheral nerve sheath tumor) is a very rare tumor of the peripheral nervous system. This type of tumor develops from cells associated with the nerve sheath known as Schwann cells. The tumor can arise in the trunk, the extremities and maxillofacial locations. The ophthalmic and maxillary trigeminal branches represent the origin of MPNST of paranasal sinuses and anterior skull base. This tumor is highly aggressive and invasive. It can spread through direct perineural invasion or the hematogenous route. Symptoms of this tumor, when located in the maxillofacial area, are unilateral nasal obstruction, epistaxis, pain, swelling of the facial region and nasal dripping. To form an adequate diagnosis, we need to combine the histological examination with MRI or CT scans. Staging of the tumor is required to plan the adequate treatment. Staging is done by combining the results of the biopsy with the imaging investigations. Treatment consists in surgical resection, followed by radiations and in case of metastatic disease, chemotherapy. Material and method This paper is a case review based on the diagnosis protocol and surgical approach that we chose for a patient that presented in our clinic with malignant Schwannoma extended in the infratemporal fossa. The procedure of choice was a combined, open and endoscopic approach, which allowed the removal of the tumor and a superior control of all hidden areas, due to the magnification offered by the endoscopy system. Conclusions Although the local recurrence of the tumor is reported to be high (up to 65%) and distant recurrence can be as high as 68%, we consider that an early diagnosis and aggressive treatment can help the longer survival of the patients and associate better outcomes. The combined approach allowed us to remove the tumor safely but associated the superior endoscopic control. Although nowadays most surgeons and patients prefer the minimally invasive approach alone, in cases with extended lesions only by associating the open approach we can achieve complete control of the lesion.
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页码:83 / 87
页数:5
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