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神经鞘瘤临床常见,但四肢多发性神经鞘瘤十分罕见.未见报道。我科收治1例,报道如下.陈某,男,42岁。住院号204495。以左手示指、足跟及右腿窝包块三年余主诉于1987年1月22日入院。其中左手示指包块曾在外院手术,内容为“豆渣”样,诊断为“粉瘤”。术后半年复发。3包块均疼且向远侧放射。查体:全身情况良好。左手示指近节桡侧包块0.5×0.5×0.5cm~3,并可见一手术疤痕;左足跟内侧半球状囊性包块2.5×2.5×0.5cm~3;右腘窝半球状囊性包块1×1×1cm~3。上述3包块均固定,有压痛并向远侧放射.不影响患肢关节活动。初诊右腘窝囊肿,左示指神经鞘瘤,左足跟腱鞘囊肿。局麻下行3包块切除,术中见右窝及左足跟包块分别与腓总神经及胫后神经有关,左手示指包块毗邻不清。病理报告均为神经鞘瘤(病理切片号870684).术后伤口Ⅰ～甲愈合.1年余后随访无复发,患肢、指感觉良好,功能无障碍.一般认为神经纤维瘤可为多发,而神经鞘瘤多为单发。曾有报道五官科见有口咽部多发神经鞘瘤,而在四肢神经干上罕见有多发神经鞘瘤,因而临床上易误诊,本例即如此。尽管病理学上神经纤维瘤与神经鞘瘤都来
The schwannomas are clinically common, but multiple schwannomas of the extremities are rare. No reports have been reported. Our department received 1 case and reported as follows. Chen, male, 42 years old. Hospital number 204495. He was admitted to the hospital on January 22, 1987 with more than three years of massification of left-handed index finger, heel, and right-leg mass. Among them, the left-handed index mass has been performed in the outer hospital and the content is “bean dregs” and the diagnosis is “a powdered tumor.” After six months of recurrence. All 3 blocks were painful and radiated distally. Physical examination: The whole body is in good condition. Left-handed index refers to the proximal sacral mass 0.5×0.5×0.5cm~3, and a surgical scar can be seen; left heel hemispherical cystic mass 2.5×2.5×0.5cm~3; right axillary hemispherical cystic mass 1×1×1cm~3. The above 3 packs are all fixed, with tenderness and radiating to the distal side. This does not affect the joint activity of the affected limb. Newly diagnosed right popliteal cyst, left finger schwannoma, left heel ganglion cyst. Under local anesthesia, 3 masses were removed and the right and left heel masses were related to the common peroneal nerve and the posterior tibial nerve, respectively. The left hand index mass was unclear. Pathology reports were all schwannomas (pathological section No. 870684). Postoperative wound I-A healing. No recurrence after 1 year follow-up, affected limbs, fingers feel good, functional barrier-free. Generally believed that neurofibroma can be multiple, The schwannomas are mostly single. It has been reported that there are multiple schwannomas in the oropharynx in the five organs, and multiple schwannomas are rarely found on the nerve trunks of the extremities. Therefore, it is clinically misdiagnosed. This is the case. Although pathological neurofibromas and schwannomas come