• Korean Journal of Head & Neck Oncology
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• v.7 no.1
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• pp.52-56
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• 1991

인체에서 발견되는 전체 신경초종중 $25{\sim}40%$가 두경부에서 발견되나 경부미주신경의 신경초종은 매우 희귀하여 1988년까지 영문문헌상 88 예가 보고되어 있다. 임상적으로 경부종괴가 주증상이며 때로는 애성, 종괴촉지시 기침 혹은 방사통, parapharyngeal space 의 종괴성장으로 연하곤란등이 초래되기도 한다. 치료는 종괴의 완전적출과 미주신경의 기능을 보존시키는 것이 주요 목표로 되어 있다. 저자들은 최근 5년간 4 예의 정부미주신경외 신경초종을 경험하였는데, 3 예는 측경부의 상부에, 1예는 측경부의 하부에 발생한 것이었다. 연령은 25세에서 50세까지 성인연령이었고, 성별은 남자 l 예, 여자 3 예이었다. 내원시 주소는 전예가 무통성 경부종괴이었으며, 종괴의 크기는 직경 3cm에서 10cm까지 다양하였다. 전예에서 종괴로 인한 신경학적 증상은 없었으나, 1 예에서 parapharyngeal space 의 거대종괴 때문에 다소간의 연하곤란이 있었다. 2 에에서는 종괴촉지시 기침이 유발됨을 호소하였다. 수술은 경부횡절개로 흉쇄유돌근을 제치고 총경 동맥과 내경정맥을 종괴의 상하부위가 완전히 노출되도록 박리한 후 종괴의 피막을 미주 신경의 주행방향에 따라 절개하여 적출 (enucleation) 하였다. 적출술시 종괴가 유착되어 있는 피막 부위는 동시에 절제하되 미주신경의 신경경로 (neural pathway) 는 유지되도록 하였다. 수술직후 2 예에서 일시적 애성을 호소하였다, 추적은 최단 20 개월에서 최장 80 개월까지 하였는데 일시적 애성은 호전되었고 전예가 재발없이 건강하게 지내고 있었다. 따라서 본 종양수술은 종양적출술시 이환된 미주신경의 절단을 결정하기 전에 신경경로를 유지시킬 수 있는 적출술 (enucleation) 을 먼저 고려하는 것이 바람직하다고 사료되었다.

• Radiation Oncology Journal
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• v.10 no.1
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• pp.77-83
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• 1992

The incidence of malignant schwannoma in the head and neck is extremely rare. Most tumors appear as a rapidly expanding nonpainful mass and the symptoms are usually attributable to local expansion of the mass. About one half occurs in association with von Recklinghausen's disease. Wide surgical excision is generally recommended as a primary treatment. Recently, there has been a trend to include postoperative radiation therapy as a primary modality. Prognosis of head and neck malignant schwannoma has been reported as particularly poor, However, recent authors advocate that prolonged survival is possible after adequate therapy including postoperative radiation therapy. We present our experience with these tumors on very rare locations such as the ethmoid sinus and the larynx, with the review of literatures.

• Journal of Chest Surgery
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• v.38 no.8 s.253
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• pp.589-593
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• 2005

Esophageal schwannoma is very rare and almost of all cases are diagnosed as esophageal submucosal tumor preoperatively. Final diagnosis is made by postoperative immunohistochemical (IHC) staining of the surgical specimen. We experienced two cases of esophageal submucosal tumor, one was 63 year old female suffering from three months of dysphagia and another was 39 year old female complaining of two months of intermittent dysphagia. Two esophageal tumors were completely removed by esophagectomy and enucleation through right thoracotomy respectively. Postoperative IHC staining demonstrated S-100 positive without mitotic figures and confirmative diagnosed was made as benign esopphageal schwannoma.

• Journal of Chest Surgery
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• v.30 no.7
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• pp.729-732
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• 1997

A case of chest wall malignant peripheral nerve sheath tumor(MPNST) was reported in the U.S.A by Mark and coworkers6)(1991), but none in korea. MPNST accounts for approximately 10% of all soft tissue sarcoma, mostly in patients between 20 and 50 years of age. MPNST arises in association with a major nerve trunk, including the sciatic nerve, brachial plexus, and sacral plexus and the most common anatomical site is the proximal portion of the upper and lower extremity and trunk. Surgical treatment is local excision of mass in low grade sarcoma but unblock resection is necessary in high grade sarcoma. We experienced multiple huge low grade MPNST on left chest wall of a 50 years old man. The tumor and invalved chest wall were removed, and the chest wall defect(15$\times$8 cm) was reconstructed with Teflon. Postoperative course was unevenful.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.461-466
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• 1994

신경초종은 신경초에서 발생되는 성장이 느린 양성 종양으로 단발성이며 드물다. 이 종양은 말초 신경,자율 신경,뇌신경의 Schwann세포에서 발생된다. 두경부 영역의 두개외 신경성 종양은 드물며 특히 타액선에서 발생되는 예는 드물다. 저자들은 20세 여자 환자에서 아래와 같은 소견을 나타내는 신경초종을 경험하였기에 보고하는 바이다. 1.주소는 좌측 악하선 부위의 종창이었으며 촉진시 3×4㎝의 단단한 종괴가 만져졌으나 동통이나 림프절병증은 없었다. 2. 일반방사선사진에서 종괴와 관련된 골변화는 없었으나 초음파 영상에서는 불균질한 반사 양상을 보이는 종괴가 좌측 악하선 영역에서 관찰되었다. 3. 자기공명영상으로 병소의 정확한 위치를 확인할 수 있었다. 병소의 경계는 명확하였으나 신호 강도는 균일하지 않았으며 T1 강조 영상에서는 근육과 유사한 신호 강도를 보였으나 T2 강조 영상에서는 근육보다 높은 신호 강도를 나타냈다. 4. 조직 병리학적으로 Antoni type B 부위보다는 A 부위가 지배적이었으며 Verocay body도 나타났다. 종양 세포는 anti-S-100 염색에 양성으로 반응하였다.

• Investigative Magnetic Resonance Imaging
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• v.15 no.2
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• pp.170-175
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• 2011

Ancient schwannoma is a rare variant of schwannoma and a slow growing benign tumor associated with degeneration that may be diagnosed as a malignant tumor, because it presents with a large size and an inhomogeneous signal intensity. The main differential diagnosis of plexiform soft tissue tumor includes plexiform neurofibroma, malignant peripheral nerve sheath tumor (MPNST). In this case, we describe the MRI findings in a case of ancient schwannoma involving left thigh of a 63-year-old woman mimicking a plexiform MPNST. The tumor appeared as an inhomogeneous signal intensity and multinodular appearance, causing misdiagnosis as a plexiform MPNST.

• Journal of Chest Surgery
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• v.37 no.12
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• pp.1019-1021
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• 2004

Neurogenic tumors are common in posterior mediastinal tumors. In most cases, tumors were accidentally showed on simple chest X-ray. In some cases, they were presented by symptoms which were induced by nerve compression or airway compression. But as in our case, neurogenic tumor with spontaneous hemothorax is very rare. A 45-year-old man admitted to emergency room of other hospital because of acute right chest pain and dyspnea. A chest X-ray showed a right pleural effusion. Hemothorax was diagnosed after closed thoracostomy. Following chest CT showed posterior mediastinal mass. The patient was transferred to our hospital. T spine MRI showed dumbbell shaped mass. Diagostic impression was neurogenic tumor. The pathologic result was neurilemmoma after surgical resection.

• Journal of Chest Surgery
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• v.38 no.3 s.248
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• pp.249-252
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• 2005

Neurogenic tumors of the brachial plexus region are relatively rare. We report a recent experience of schwannoma of the right brachial plexus in the inferior trunk, which was successfully treated by microsurgical resection. A 38-year- old man presented a dysesthetic pain in the supraclavicular area and the right forearm of C6, 7 dermatome. Rubbery hard mass was palpated in the right supraclavicular area and magnetic resonance imaging showed a well circumscribed, well enhanced ovoid mass with cystic degeneration on the right brachial plexus portion. The patient underwent complete removal of the mass through the anterior cervicothoracic (modified Dartevelle) approach. At the postoperative 3 months, there is no neurologic deficit.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.44-50
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• 1999

Neurilemmoma is a benign encapsulated nerve sheath tumor originated from peripheral nerve. Previously its preoperative diagnosis had mainly depended on the history, physical examination, electrodiagnostic test, ultrasonography, bone scan. But only with these diagnostic modalities, exact preoperative diagnosis was nearly impossible. Therefore operation was performed under the impression of lipoma or just simple soft tissue tumor. Recently, the advent of magnetic resonance imaging(MRI) has made it easier to diagnose neurilemoma before surgery. MRI also helps to determine the extent of lesion and operative procedures. We performed marginal excision in 24 cases, evaluated those cases with respect to the sex, age, location, chief complaint, duration of illness, preoperative diagnosis, involved nerve, imaging studies, size of mass, complication, duration of follow-up and report with review of the literature.

• 대한두경부종양학회:학술대회논문집
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• 1993.11a
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• pp.262.1-262.1
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• 1993