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| 題 名 | Wrist Schwannoma Mimicking De Quervain's Disease: A Case Report=許旺氏細胞瘤引起類似De Quervain氏症:病例報告 |
|---|---|
| 作 者 | 陳鵬安; 賴仲亮; 蔡明妙; 呂傳欽; 王亭貴; | 書刊名 | 臺灣復健醫學雜誌 |
| 卷 期 | 39:3 2011.09[民100.09] |
| 頁 次 | 頁181-186 |
| 分類號 | 416.13 |
| 關鍵詞 | 骨骼肌肉超音波; De Quervain氏症; 肌腱病變; 許旺氏細胞瘤; Ultrasonography; De Quervain's disease; Tendinopathy; Schwannoma; |
| 語 文 | 英文(English) |
| 中文摘要 | 近十年以來,超音波檢查常常被應用在軟組織腫瘤的評估。隨著影像技術進步與醫學影像的發展,評估病灶準確度也越來越高。在這個病例報告中,一個80歲的男性從兩年多前開始左拇指疼痛,症狀與臨床表現與de Quervain氏症相同,所以一直以來被當作de Quervain氏症治療。由於保守治療反應不佳,病患於一年後接受了筋膜放鬆手術(tenosynovectomy),不過術後並無如預期復原,病患的左拇指持續疼痛。在沒有改善的情形下,病患於是來到大醫院就醫,於是幫他安排了超音波。檢查結果發現一顆9.3×7.3×11.6mm的腫瘤,位於外展拇長肌腱(abductor pollicis longus tendon)下方,邊緣清楚,內部呈現均質低回音,血管訊號增加,初步懷疑是神經性腫瘤(neurogenic tumor)。在接受核磁共振造影檢查證實後,病患決定接受腫瘤切除,病理報告證實是許旺氏細胞瘤(Schwannoma)。腫瘤切除後,病患的症狀完全恢復。結語:超音波檢查提供了快速、方便、不具侵犯性的優點,特別在動靜態結構檢測爲其強項。對於一些保守治療甚至手術治療均無效的肌腱炎病患,超音波可納入常規檢查,幫助排除腫瘤、空間佔據病灶、動靜態結構異常、及其他比較罕見的病因。 |
| 英文摘要 | For decades, ultrasonography has shown a high degree of accuracy in the evaluation of soft tissue tumors. In this study, we report the condition of a 80-year-old male patient who had been suffering from left thumb pain for 2 years. The patient had initially been diagnosed with de Quervain's disease, but responded poorly to conservative treatment. An ultrasonographic examination unexpectedly identified a well-margined solid tumor with marked vascularity. Suspicion of a neurogenic tumor led to an excision surgery and finally pathology revealed a Schwannoma. Following excision, the symptoms were entirely ameliorated. We concluded that, in the evaluation of persistent chronic tenosynovitis, ultrasonography ought to be mandatory, due to its effectiveness in detecting tumors and structural abnormalities. |
本系統中英文摘要資訊取自各篇刊載內容。