Posterior Cervical Intramuscular Schwannoma Within the Trapezius Muscle: A Case Report.

IF 0.7 Q4 OTORHINOLARYNGOLOGY
Turkish Archives of Otorhinolaryngology Pub Date : 2022-06-01 Epub Date: 2022-08-31 DOI:10.4274/tao.2022.2022-1-8
Naoto Koike, Hisashi Hasegawa, Hiroumi Matsuzaki, Takeshi Oshima
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Abstract

Schwannomas are benign soft tissue tumors derived from the Schwann cells of the peripheral nerves. An intramuscular schwannoma arising within the trapezius muscle in the posterior neck is rare. We report a case of a 31-year-old woman with an intramuscular schwannoma in the trapezius muscle. A painless and smooth-surfaced mass from 10 years ago was evident on palpation in the right posterior neck. Ultrasonography revealed an oval mass with clear borders and slight internal blood flow. No continuous hypoechoic lesions were noted at the tip of the mass. Magnetic resonance imaging of the neck revealed a mass in the right posterior cervical trapezius muscle with isointensity on T1-weighted imaging and heterointensity on T2-weighted imaging. Based on these findings, a schwannoma was suspected. Ultrasonography guided fine needle aspiration cytology revealed no significant findings. During surgery, a white-colored, encapsulated-tumor mass was found in the trapezius muscle. Histopathologically, hypocellular and hypercellular areas of fusiform cells were conspicuous, and nuclear palisading was observed in a part of the hypercellular region, confirming the diagnosis of schwannoma. To our knowledge, this is an extremely rare report of an intramuscular schwannoma within the trapezius muscle; herein, we report its clinical, radiological, and pathological features.

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颈后斜方肌肌内神经鞘瘤1例报告。
神经鞘瘤是源自周围神经的雪旺细胞的良性软组织肿瘤。肌内神经鞘瘤产生于斜方肌在后颈部是罕见的。我们报告一例31岁女性斜方肌肌内神经鞘瘤。右后颈部触诊可见10年前无痛、表面光滑的肿块。超声显示一个椭圆形肿块,边界清晰,内部有少量血流。肿块尖端未见连续低回声病变。颈部磁共振成像显示右侧颈后斜方肌肿块,t1加权成像等强度,t2加权成像异强度。基于这些发现,我们怀疑是神经鞘瘤。超声引导下细针穿刺细胞学检查未见明显变化。手术中,在斜方肌中发现一个白色的包裹性肿瘤块。组织病理学上梭状细胞低细胞区和高细胞区明显,部分高细胞区可见核栅栏,证实神经鞘瘤的诊断。据我们所知,这是一个非常罕见的斜方肌肌内神经鞘瘤的报告;在此,我们报告其临床,放射学和病理特征。
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