阴茎神经鞘瘤一例报告并文献复习  

Penile schwannoma：one case report and literature review

作　　者：杨斌[1] 刘久华[1] 张明聪[1] 程伟[1] 辛锋[1] Yang Bin;Liu Jiuhua;Zhang Mingcong;Cheng Wei;Xin Feng(Departmemt of Urology,the Second People＇s Hospital of Lianyungang,Liangyungang,Jiangsu 222006,China)

机构地区：[1]连云港市第二人民医院东院泌尿外科,江苏省连云港222006

出　　处：《中国基层医药》2018年第19期2508-2511,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的 探讨阴茎神经鞘瘤的临床病理特征及治疗方法.方法 报告1例阴茎神经鞘瘤患者诊治结果,结合文献进行分析,探讨该病的组织发生及诊治特点.以＂penis＂或＂penile＂联合＂schwannoma＂或＂neurilemmoma＂及＂阴茎神经鞘瘤＂为检索词查阅PubMed及万方数据库截至2017年4月的相关文献.结果患者男,40岁,因＂阴茎根部肿块进行性增大1年＂于2015年10月入院,查体于阴茎根部背侧皮下可触及1.2 cm×0.8 cm质硬肿块,肿块表面光滑,无明显触痛,活动性可.无多发性神经纤维瘤病史.彩超发现阴茎根部皮下1.7 cm×0.4 cm低回声影,与阴茎海绵体分界清晰,其内未见明显血流信号.局麻下行阴茎肿块切除术.病理肉眼见1.5 cm×1.0 cm×0.7 cm白色质软肿块;镜下见Antoni A型,细胞丰富,细胞核呈栅栏状;免疫组化：S-100（＋＋＋）,SMA（-）,Act（-）.病理诊断：阴茎神经鞘瘤.术后恢复好,随访18个月无勃起功能障碍及复发.中文文献共检索到阴茎神经鞘瘤14例,其中恶性1例,余均为良性;英文文献共33例,其中恶性6例.发病年龄平均为39.2岁,肿瘤大部分位于阴茎背侧,临床表现及影像学检查无特异性,确诊主要依靠病理诊断,大部分肿瘤为良性,局部切除术治疗效果好.结论 阴茎神经鞘瘤临床极其罕见,缺乏典型的临床表现,影像学检查无特异性,确诊主要靠病理检查,免疫组化标记物S-100有助于确诊.良性阴茎神经鞘瘤手术切除治疗效果好,无复发及性功能障碍.恶性阴茎神经鞘瘤诊断困难,术后局部复发再次手术病理才确诊,需手术联合放化疗,预后不佳.Objective To evaluate the clinical and pathological characteristics and treatment of penile schwannoma.Methods One case of penile schwannoma was reported,and the relevant literature was reviewed to investigate the histogenesis,diagnosis and treatment of this disease.Related literature from PubMed and Wanfang databases to date（up to April 2017）with＂penis＂ or＂penile＂ combined with ＂schwannoma＂ or＂neurilemmoma＂ as search terms was reviewed.Results One 40-year-old male presented in October 2015 with a tumor at the root of the dorsal penis for 1 year.Physical examination revealed a non-tender,easily movable without adhesion to the skin,1.2cm ×0.8cm nodule at the root of the dorsal penis,the overlying skin was smooth and intact.No evidence of neurofibromatosis was found.Hypoechoic well-defined nodule（1.7cm ×0.4cm）located between the superficial skin and corpus cavernosum was showed on ultrasound without blood flow signal.Simple excision of the tumor was performed under local anesthesia.Grossly,the tumor was a well-defined,white,soft 1.5cm ×1cm ×0.7cm nodule.Microscopically,the tumor was composed of Antoni A area with hypercellular and nuclear palisading.Immunohistochemical staining showed S-100（＋＋＋）,SMA（-）,Act（-）.The pathological diagnosis was penile schwannoma.Postoperatively,the patient recovered well without erectile dysfunction.During a follow-up 18 months,the patient had no recurrence.By literature review,we found 14 cases in Chinese articles with one malignant case,while 33 cases in English articles with six malignant cases.The average age of onset was 39.2 years.Most of the tumors are benign and located in the dorsal side of the penis.Penile schwannoma can be diagnosed properly based on pathological examination,owing to the lack of typical clinical and imaging manifestation.The tumor resection was the treatment of choice for benign penile schwannoma without postoperative complications.Conclusion Penile schwannoma is extreme rarity,but can be diagnosed properly based

关 键 词：阴茎肿瘤 神经鞘瘤 

分 类 号：R737.27[医药卫生—肿瘤]