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PL
Schwannoma (nerwiaki osłonkowe) to łagodne, dobrze odgraniczone guzy powstające z komórek Schwanna, tworzących osłonki mielinowe nerwów obwodowych, czaszkowych lub korzeni nerwów rdzeniowych. 25–45% z nich lokalizuje się w obrębie głowy i szyi, głównie w przestrzeni przygardłowej. Lokalizacja wewnątrzprzyusznicza jest rzadko spotykana. Etiologia nowotworu nie jest znana. Diagnostyka przedoperacyjna zarówno radiologiczna, jak i cytologiczna jest trudna i często nie daje prawidłowego rozpoznania. Radiologicznie zwykle podejrzewany jest gruczolak wielopostaciowy, a materiał z biopsji cienkoigłowej nie jest diagnostyczny. Leczenie z wyboru to chirurgiczne usunięcie zmiany z próbą zachowania funkcji nerwu twarzowego.
EN
Introduction: Neuroma (Schwannoma in Latin) is an encapsulated, mesenchymal tumor arising from Schwann cells surrounded by nerves. Hence it can be located in any area in the body with passing peripheral nerves. The most common location is the head, neck, and extremities. The tumor arising from Schwannoma cells was first described by Stout and Carson in 1935. Pancreatic schwannomas are extremely rare tumors. Until 2017, in English literature 68 cases have been described. Surgical treatment is the most common way of treating pancreatic schwannomas, and postoperative prognoses are good. Case report: A 63-year-old patient was admitted to the Clinical Department of Gastroenterological Surgery and Transplantation of the Central Clinical Hospital at the Ministry of Interior and Administration in Warsaw due to pancreatic head cancer. Needle biopsy–both ultrasound-guided and CT-guided as well as open biopsy for lesions in the pancreas did not show tumor cells in any of the collected samples. Abdominal CT in a projection of the uncinate process of the pancreas revealed an oval lesion highly suspected of neoplastic process. Next, diagnostics was extended by abdominal MRI which revealed a retroperitoneal tumorous thick-walled cystic mass filled with fluid. The patient was qualified for surgical treatment. Pancreaticoduodenectomy (Whipple Procedure) was done on August 22, 2017. Material sent for histopathological examination revealed Schwannoma capitis pancreatis. In surgical practice, pancreatic schwannoma occurs extremely rare, but in centers which conduct large numbers of surgical procedures in the pancreas, a case like this may occur.
EN
Schwann cell tumour is a rare benign neoplasms, which in approximately 25–45% of cases localises in the head and neck region. The half of them is found intracranially, within the cochleovestibular nerve (n. VIII) leading to deef. The slow growth and the lack of characteristic clinical signs influence clinically silent development of the tumour. Presence of the clinical signs may by connected with the pressure on the surrounding anatomical structures or the damage of the affected nerve. The treatment of the choice of the extracranial tumours is surgical resection. In presented case, the tumour development was signless. The attempt of the tumour enucleation was taken. Because of the difficulties with the tumour extracapsular enucleation, the decision of radical resection of the tumour and a part of the vagal nerve had been made. The vagal Schwann cell tumour is benign and rare neoplasm, that should be resected, despite it doesn’t influence the suspected patients survival. The main problem stands for the complications due to the nerve damaging during the surgery.
EN
The study presented a case of a patient with a neurilemoma of the median nerve. It presented as a six centemeters tumor, at the level of the proximal one third of the arm with only mild paraesthesias within frst to third ray of the hand. MRI showed the relationship of the tumor and the median nerve, and allowed for the preliminary diagnose of a benign peripheral neural sheath tumor (neurilemoma or neurofibroma). During the first operation the tumor has not been excised, because nerve reconstruction technique was not available. During the second procedure excision of the tumor has been performed without resection of the median nerve trunk with no postoperative deficiencies. The paper provides a detailed description of a surgical procedure. The presented case, like current publications shows that peripheral neural sheath tumor may be usually excised without resection of the nerve trunk, although the possibility of nerve fascicles injury or the need to excise them in the case of neurofibroma clearly suggest that these type of operations should be carried out in centers with microsurgical facilities.
EN
Schwannomas are benign tumors derived from glial cells of peripheral nerve sheaths. They usually occur in association with Von Recklinghausen‘s disease and most commonly are observed on the head, neck, and upper extremities. Rare morphological variants may be misinterpreted as a malignancy under microscopic examination. The study presented a case of a sporadic “ancient” Schwannoma cell tumor located in the retroperitoneum. Literature data concerning diagnosis and treatment of the above-mentioned pathology was also reviewed.
EN
Schwann cell tumours are a rare group of benign neoplasms that origin form peripheral nerves. 0.1%–1.5% develops in the larynx causing hoarseness, difficulty swallowing and dyspnoea. The treatment of choice is surgical resection of the tumour during open type surgery or endoscopic procedure. The chosen surgical technique depends on tumour location, size observed in clinical examination and imaging. Also, clinical manifestation of the disease is included in the decision-making process.
PL
Wprowadzenie: Schwannoma (nerwiak osłonkowy, łac. neurilemmoma) to łagodny, wolno rosnący i heterogenny nowotwór, wywodzący się z komórek Schwanna. Najczęściej lokalizuje się on w: głowie, szyi i kończynach. Może jednak występować również w skórze lub miąższu piersi oraz w tkankach miękkich pachy. Opis przypadku: W niniejszej pracy opisano przypadek 51-letniej kobiety z podejrzeniem złośliwej zmiany w piersi, u której w pooperacyjnym badaniu histopatologicznym zdiagnozowano schwannoma. Jeśli w piersi obecna jest wyczuwalna palpacyjnie zmiana, to w diagnostyce różnicowej należy uwzględnić nerwiaka osłonkowego. Mimo że w diagnostyce zmian w piersiach stosuje się różne badania obrazowe, to w celu postawienia ostatecznej diagnozy nerwiaka konieczne jest wykonanie biopsji wycinkowej lub gruboigłowej.
EN
The authors present a case report of a 46-year-old man with a tumor of the posterior pharyngeal wall. Based on clinical examination and magnetic resonance imaging, the patient was qualified for surgical treatment. The patient underwent tumor resection under general anesthesia. Histopathological examination of resected tumor revealed the diagnosis of ancient schwannoma.
EN
Meningiomas are one of the most common intracranial neoplasms, usually located in the supratentorial region. Their location within the posterior cranial fossa is rare, but even in such cases, the diagnosis is possible owing to the characteristic imaging features. In this article, we present a case report of a patient with a meningioma of an internal acoustical meatus resembling vestibulo-cochlear nerve schwannoma in its typical location, causing symptoms such as asymmetric hearing loss, tinnitus and dizziness.
EN
The report aims to present a rare case of facial nerve schwannoma within the parotid gland. Schwannomas are benign, welldefined tumours arising from Schwann cells that form the myelin sheaths of peripheral, cranial or spinal nerves. 25–45% of them are located within the head and neck, mainly in the parapharyngeal space. The intraparotid localisation is rare. The aetiology of cancer is unknown. Preoperative diagnosis, both radiological and cytological, is difficult and often does not give the correct diagnosis. Radiologically, a multiform adenoma is usually suspected, and fine needle aspiration biopsy is nondiagnostic. Due to the rarity and benign nature of the tumour, there has been debate over the need for surgical treatment.
PL
Oponiaki to jedne z najczęstszych nowotworów wewnątrzczaszkowych głównie lokalizujące się w przestrzeni nadnamiotowej. Ich lokalizacja w tylnym dole czaszki jest zjawiskiem niespotykanym, ale nawet wtedy poprawne postawienie diagnozy ułatwiają charakterystyczne cechy napotkane podczas analizy badań obrazowych. W niniejszej pracy autorzy prezentują przypadek chorego z oponiakiem przewodu słuchowego wewnętrznego przypominającym schwannoma nerwu przedsionkowo-ślimakowego o typowej lokalizacji, a także wywołującym typowe objawy, takie jak asymetryczne pogorszenie słuchu, szumy uszne i zaburzenia równowagi. Ponadto w artykule przedyskutowany zostaje rozwój i diagnostyka oponiaka, a także możliwość jego leczenia w kontekście tak osobliwej lokalizacji.
EN
Introduction: Schwannoma (neurilemmoma) is a kind of a slow-growing, benign, and heterogeneous neoplasm originating from Schwann cells. Schwannoma has a predilection for the head, neck, and extremities. However, it can occur in the breast dermis, deep breast parenchyma, and axillary soft tissue. Case report: In this study, a 51-year-old woman is reported with a breast mass suspected of malignancy, who was diagnosed with schwannoma by a pathologist after surgery. In cases with palpable breast masses, Schwannoma should be considered as a part of differential diagnosis. In spite of various imaging modalities used in the diagnostics of breast lesions, excisional or core needle biopsy is suggested for the definitive diagnosis of schwannoma.
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