Thoracic Neurogenic Tumours
Küçük Resim Yok
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İntratorasik nörojenik tümörler mediastumun nörojenik yapılarından kaynaklanırlar. Schwannom ve nörofibromlar sinir kılıfından, ganglionörom ve nöroblastomlar ise otonomik ganglionlardan gelişirler. Çalışmadaki amacımız mediastinuma uzanım gösteren bu tümörleri klinik ve patolojik olarak tanımlamaktır. Yöntem: 2008-2012 tarihleri arasında mediastinuma uzanan nörojenik tümör tanısı ile opere edilen toplam 16 hastanın (10 erkek,6 kadın) klinik bilgilerine retrospektif olarak ulaşıldı. Hastaların yaşları 5 ile 66 olup ortalama yaş 46 idi. Hastalar cerrahi kliniğe kabul edilip detaylı fizik muayene ve rutin 2 yönlü göğüs grafileri ardından elektrokardiografi ve standart kan testlerine tabii tutulmuşlardı. Tümör lokalizasyonu ve natürünü tespit açısından bilgisayarlı toraks tomografisi tüm hastalara uygulanmıştı. Özellikle interspinal aralığa uzanan ve vasküler invazyon düşünülen olgulara Magnetik rezonans görüntüleme yapılmıştır. Sonuçlar: Preoperatif semptomlar 13 (%81) hastada görülmüştür. Bunlar sırt ağrısı ve göğüs ağrısı 10 (%63) hastada, nefes darlığı 3 (%19) hastada tesbit edilmiştir. Tüm hastalarda CT solid bir tümör olduğu tesbit edilmiştir. Lokalizasyonlarına göre posterior mediastende 10 (%63) , üst mediastinumda 2 (%13) ve göğüs duvarında 4 (%25) olgu tespit edilmiştir. Hhistopatolojik tanılarına göre 3 olguda (%19) ganglionorinoma, 3 olguda (%19) nörofibroma, 9 olguda (%56) schwannoma ve 1 olguda (6%) malign periferik sinir kılıfı tümörü tesbit edilmiştir. Tüm hastalarda cerrahi komplet rezeksiyon sağlanmıştır. Cerrahi olarak 13 (%81) tümör torakotomi ile ortadan kaldırılmış, 1 (%6) olgu video yardımlı torakoskopik yaklaşım ile opere edilmiştir.2(13%) hastada ise tümör göğüs duvarından eksize edilmiştir. Tartışma: Cerrahi endikasyon tam olarak konulduktan sonra komplet rezeksiyon ile yüz güldürücü sonuçlar alınmaktadır. Magnetik rezonans görüntüleme ise lezyonun natürü, yayılımı ve invazyon açısından büyük yarar sağlamaktadır. Postoperatif takiplerde komplet rezeksiyon sonrası iyi bir progres sağlamaktadır.
Intrathoracic neurogenic tumours are neoplasms arising from any of the neurogenic elements of the mediastinum. Schwannomas and neurofibromas develop from nerve sheath, ganglioneuromas and neuroblastomas from autonomic ganglions. The aim of in this study we present the clinical and pathological details of these patients and to determine only extending the mediastinum. Materials and methods: We reached retrospective clinical data of 16 patients (10 males and 6 females) with neurogenic tumours of the mediastinum undergoing surgical treatment 2008 to 2012. Age of the patients ranged from 5 to 66 years (mean 46 years). When the patients admitted our clinic to surgery. All patients had detailed history and physical examination, routine chest radiography, electrocardiography and standard laboratory blood tests. For localizations and to define the nature of the tumour whole the patients were performed computed tomographic (CT). Especially when we suspected involvement of intervertebral space and vascular space magnetic resonance imaging. Results: Preoperative symptoms were observed in 13 cases (%81), as follows: back and thoracic pain in 10 (%63), short of breathness in 3 (%19) patient.The preoperative CT showed the tumour as a solid lesion in 16 cases. The tumour was located on the posterior mediastinum in 10 (%63) patients and cases.2 (%13) patients upper mediastinum and 4 (%25) patients from thoracic wall. The histological type of the tumours was in 3 (%19) cases, ganglioneuroma, in 3 (%19) cases benign neurofibroma, in 9 (%56) cases schwannomas. 1 (%6) case originated from malignant peripheral nerve sheet tumour (MPNST). Complete surgical excision was achieved in all patients, with no postoperative mortality. There was no significant intraoperative and postoperative blood loss and no major surgical complications occurred. Conclusions: After the surgical indications may be carefully determined in cases. There is a good result in these tumours. MRI would facilitate therapeutic determination by distinguishing nature, spread and invasion of the neurogenic tumour. Patient with benign neurogenic tumours have a good survival prospect following operations.
Intrathoracic neurogenic tumours are neoplasms arising from any of the neurogenic elements of the mediastinum. Schwannomas and neurofibromas develop from nerve sheath, ganglioneuromas and neuroblastomas from autonomic ganglions. The aim of in this study we present the clinical and pathological details of these patients and to determine only extending the mediastinum. Materials and methods: We reached retrospective clinical data of 16 patients (10 males and 6 females) with neurogenic tumours of the mediastinum undergoing surgical treatment 2008 to 2012. Age of the patients ranged from 5 to 66 years (mean 46 years). When the patients admitted our clinic to surgery. All patients had detailed history and physical examination, routine chest radiography, electrocardiography and standard laboratory blood tests. For localizations and to define the nature of the tumour whole the patients were performed computed tomographic (CT). Especially when we suspected involvement of intervertebral space and vascular space magnetic resonance imaging. Results: Preoperative symptoms were observed in 13 cases (%81), as follows: back and thoracic pain in 10 (%63), short of breathness in 3 (%19) patient.The preoperative CT showed the tumour as a solid lesion in 16 cases. The tumour was located on the posterior mediastinum in 10 (%63) patients and cases.2 (%13) patients upper mediastinum and 4 (%25) patients from thoracic wall. The histological type of the tumours was in 3 (%19) cases, ganglioneuroma, in 3 (%19) cases benign neurofibroma, in 9 (%56) cases schwannomas. 1 (%6) case originated from malignant peripheral nerve sheet tumour (MPNST). Complete surgical excision was achieved in all patients, with no postoperative mortality. There was no significant intraoperative and postoperative blood loss and no major surgical complications occurred. Conclusions: After the surgical indications may be carefully determined in cases. There is a good result in these tumours. MRI would facilitate therapeutic determination by distinguishing nature, spread and invasion of the neurogenic tumour. Patient with benign neurogenic tumours have a good survival prospect following operations.
Açıklama
Anahtar Kelimeler
Nörolojik Bilimler
Kaynak
Journal of Neurological Sciences (Turkish)
WoS Q Değeri
N/A
Scopus Q Değeri
Cilt
30
Sayı
2
