Malignant transformation of benign intraosseous schwannoma in the cervical spine: a case report with an immunohistochemical study.
Malignant transformation of benign intraosseous schwannoma in the cervical spine: a case report with an immunohistochemical study.
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颈椎良性骨内神经鞘瘤的恶性转化：免疫组织化学研究的病例报告。
DOI：
10.9738/cc42.1
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发表时间：
2011
影响因子：
0.1
通讯作者：
X. Zou
中科院分区：
文献类型：
--
作者：
Xinsheng Peng;Li;Hong Du;Yingrong Lai;Fo;X. Zou
虽然在von Recklinghausen病中有3%到30%的病变发生恶变，但良性孤立性神经鞘瘤的恶变是非常罕见的。我们报告一位44岁的男性颈椎良性骨内神经鞘瘤复发并恶变的病例，患者表现为C3椎体的巨大肿瘤，具有侵袭性、膨胀性和溶骨性破坏，在手术切除和脊柱重建后2年复发。在随访期间记录临床资料、影像学特征、手术处理、组织病理学和免疫组化特征。局部复发、核多形性、上皮样分化、少量S-100蛋白阳性细胞，尤其是p53（80%）和Ki-67（75%）蛋白阳性细胞的高比例支持颈椎良性骨内神经鞘瘤恶变的侵袭性。免疫组化可作为辅助诊断技术。我们的做法是建议这种情况下，必须仔细切除和病人随访。
Although 3% to 30% of lesions in von Recklinghausen disease undergo malignant transformation, malignant transformation of benign solitary schwannoma is extremely rare. We reported a case of recurrence and malignant transformation in a benign intraosseous schwannoma arising in the cervical spine of a 44-year-old man. The patient presented giant tumor in the C3 vertebral body with aggressive, expansile, and osteolytic destruction and relapsed 2 years after surgical resection and spinal reconstruction. Clinical data, radiologic characteristics, surgical management, histopathologic and immunohistochemical features were noted in the duration of follow-up. The local recurrence, nuclear pleomorphism, epithelioid differentiation, a small number of positive S-100 protein-staining cells, and especially the high percentage of positive cells with p53 (80%) and Ki-67 (75%) proteins support the aggressive nature of the lesion in malignant transformation of benign intraosseous schwannoma in the cervical spine. Immunohistochemistry would be useful as an ancillary technique in diagnosis. It is our practice to suggest that such case has to be carefully resected and the patient followed up.