26例颌面部神经鞘瘤误诊原因分析

Analysis of preoperative misdiagnosis causes in 26 cases of neurolemmoma

目的:分析颌面部神经鞘瘤误诊原因,进一步提高临床诊断治疗水平。方法:回顾26例颌面部神经鞘瘤误诊病例资料,总结分析误诊原因,以及治疗过程中存在和注意的问题。结果:26例误诊病例,术前诊断腮腺多形性腺瘤4例,腮腺恶性肿瘤3例,颧骨骨瘤1例,颈动脉体瘤4例,鳃裂囊肿1例,恶性肿瘤颈淋巴结转移3例,咽部恶性肿瘤2例,舌部纤维瘤4例,口底皮样囊肿2例,舌下腺恶性肿瘤2例。26例术后病理均证实为神经鞘瘤。结论:临床表现为局部肿块的颌面部神经鞘瘤,易与其他肿瘤混淆,应特别注意与类似病变鉴别诊断。

PURPOSE: To improve the understanding of the diagnosis and treatment of neurolemmoma in maxillofacial region by summarizing its clinical features. METHODS: The preoperative misdiagnosis causes and treatment in 26 cases of neurolemmoma were reviewed. RESULTS: Among all cases treated surgically, 4 cases were pleomorphic adenoma of the parotid gland; 3 cases were malignant tumor of the parotid gland; 1 case was zygomatic osteoma; 4 cases were carotid body tumor; 1 case was branchial cleft cysts; 3 cases were cervical lymph node metastasis; 2 cases were pharyngeal malignant tumor; 4 cases were fibromatosis of the tongue; 2 cases were dermoid cyst; 2 cases were sublingual gland tumor. CONCLUSION: It is difficult to diagnose neurolemmoma before operation, however, it is important to carefully protect the function of the nerve in order to avoid severe complications .