Large schwannoma of the median nerve at the distal forearm

Dejan Vulović; Jefta Kozarski; Tatjana Vulović; Marko Spasić; Tatjana Šarenac Vulović; Tahir  Ahmed T. Mubarak; Vesna Stanković; Mubarak  Al-Shraim; Dejana Rakić

doi:10.2298/VSP211010034V

Dejan Vulović University Clinical Center Kragujevac, Center for Plastic Surgery, Kragujevac, Serbia
Jefta Kozarski Military Medical Academy, Clinic for Plastic Surgery and Burns, Belgrade, Serbia
Tatjana Vulović University of Kragujevac, Faculty of Medical Sciences, Department of Surgery Kragujevac, Serbia
Marko Spasić University of Kragujevac, Faculty of Medical Sciences, Department of Surgery Kragujevac, Serbia
Tatjana Šarenac Vulović University Clinical Center Kragujevac, Clinic for Ophtalmology, Kragujevac, Serbia
Tahir Ahmed T. Mubarak Aseer Central Hospital, Plastic Surgery and Burn Department, Abha, Kingdom of Saudi Arabia
Vesna Stanković University Clinical Center Kragujevac, Centre for Pathological Anatomical Diagnostics, Kragujevac, Serbia
Mubarak Al-Shraim King Khalid University, College of Medicine, Department of Pathology, Abha, Kingdom of Saudi Arabia
Dejana Rakić University Clinical Center Kragujevac, Clinic for Gynecology and Obstetrics, Kragujevac, Serbia

DOI: https://doi.org/10.2298/VSP211010034V

Ključne reči: dijagnoza, n. medianus, švanom, nervni sistem, periferni, neoplazme, švanove ćelije

Sažetak

Uvod. Švanom, poznat i kao neurilemom, je redak ali jedan od najčešćih tumora perifernih nerava. Potiče od Švanovih ćelija nervnog omotača. Švanom se najčešće javlja kod odraslih osoba, između 20 i 70 godina starosti. Uglavnom se javlja na glavi i vratu, ali se može pojaviti na skoro svim delovima tela ili u organima. Švanomi su najčešće veličine do 2,5 cm, ali mogu dostići i dimenzije do 4–5 cm. U ovom radu prikazan je bolesnik sa švanomom medijalnog nerva u distalnom delu podlaktice. Prikaz bolesnika. Osoba muškog pola, starosti 46 godina, upućena je specijalisti platične hirurgije, sa dijagnozom lipoma na prednjoj strani distalne trećine leve podlaktice. Urađeni su ultrasonografija i magnetska rezonanca, a nakon toga je urađena operacija. Utvrđeno je da se radi o inkapsuliranom tumoru medijalnog nerva i tumor je uklonjen u celini, bez oštećenja nerva. Histološka analiza je pokazala da se radilo o benignom švanomu celularnog tipa i bifaznog oblika. U postoperativnom toku postojala je prolazna parestezija. Godinu dana nakon operacije nije zabeležen recidiv tumora, niti neurološki deficit. Zaključak. Švanom je najčešći benigni tumor perifernih nerava. Švanomi dimenzija preko 5 cm su izuzetno retki. Adekvatan klinički pregled, preoperativna dijagnostika i histološka verifikacija neophodni su za postavljanje konačne dijagnoze. Kompletna hirurška ekscizija velikih švanoma je metoda izbora u lečenju ovih tumora.

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Veliki švanom medijalnog nerva u distalnom delu podlaktice

Sažetak

Reference