复杂血管毗邻的腹膜后神经鞘瘤的手术切除2例报告

Surgical resection of retroperitoneal neurilemmoma adjacent to complex blood vessels: a report of 2 cases

目的报道2例严重压迫下腔静脉、右肾静脉等血管的腹膜后神经鞘瘤手术成功切除病例,分析其临床诊治现状。方法对2例患者通过三维重建和其他影像学检查进行术前诊断、手术治疗、术后病理确诊,术后进行随访。结果2例患者均完整切除病灶,无周围血管及脏器损伤,术后病理证实为腹膜后神经鞘瘤,随访无复发。结论腹膜后神经鞘瘤较罕见,术前诊断困难,确诊需通过组织病理学。体积较大、复杂血管毗邻的良性肿瘤仍可以手术完整切除,且预后良好,复发率低。

Objective To analyze the clinical diagnosis and treatment of two cases of retroperitoneal neurilemmoma with severe compression of inferior vena cava and right renal vein.Methods Preoperative diagnosis by 3D reconstruction and other imaging examinations were made.Then surgical treatment,postoperative pathological diagnosis and follow-up were preformed in 2 patients.Results The tumours were resected completely in 2 cases without peripheral blood vessels and viscera injury.The postoperative pathology was retroperitoneal neurilemmoma.No recurrence was found at follow-up.Conclusion Retroperitoneal schwannoma is rare and difficult to diagnose before operation.The large benign tumors adjoining complex blood vessels can still be resected completely,and there is good prognosis and low recurrence rate.