neurogenic tumor
Introduction
Introduction to neurogenic tumors Neurogenic tumors are the most common primary posterior mediastinal tumors, most of which occur in the posterior mediastinal paravertebral sulcus. A small number of tumors can occur partially in the intervertebral foramen, making the tumor grow like a dumbbell. Pathologically benign, including schwannomas, neurofibromas, and ganglioneuromas, malignant schwannoma (neurosarcoma), ganglion neuroblastoma, and sympathetic neuroblastoma. Less common are benign and malignant pheochromocytoma from the paraganglia, which can secrete adrenaline and are clinically fluctuating. Tumors occur in young and middle-aged children, and children are more common in ganglioneuroma and ganglion neuroblastoma. Multiple neurofibromas, in addition to the mediastinum, can be found in other nerves, accompanied by multiple skin nodules, purple spots and bone changes, called neurofibromatosis. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: sphincter-derived tumors, neuroendocrine tumors
Cause
Neurogenic tumor etiology
The specific cause is unknown, and many factors cause illness.
Prevention
Neurogenic tumor prevention
The following foods are strictly prohibited: oil press, pickled, cola, burger, milk, nuts, beans, leeks, snacks. Traditional Chinese medicine advocates appropriate taboos, and Western medicine generally does not advocate taboos. Western medicine attaches great importance to the relationship between diet and disease, and it is not against taboos. For example, food contaminated with aflatoxin cannot be eaten; charred foods tend to denature proteins, pyrolysis and heat accumulation are prone to polycyclic aromatic hydrocarbon compounds, Harmful and not advocate eating, smoked fish, bacon does not advocate eating more, wine can reduce the body's detoxification function and biotransformation function, so that immunity is reduced, wine increases carcinogen activity in the body, and has cytotoxicity, it should not Drinking alcohol.
Complication
Neurogenic tumor complications Complications, neuroscleral tumors, neuroendocrine tumors
About 80% of patients in China have found malignant tumors in the middle and late stages, and the most common cause of pain, disability and death is tumor complications. The basic content of tumor complications is: direct or indirect caused by malignant tumors during the development process; iatrogenic problems caused by surgery, radiotherapy and chemotherapy (including diagnosis). The causal relationship formed by this and the other can be described as "the fire of the city gate, the fish and the fish." Even if certain complications are found to be timely and properly handled, it will determine whether the tumor can be cured or seek further treatment and obtain long-term survival opportunities. The harm is self-evident.
Symptom
Neurogenic tumor symptoms common symptoms secondary optic atrophy nerve loss nerve root injury
The tumor is located in the upper part of the lateral aspect of the neck, deep in the sternocleidomastoid muscle. With a round or round shape, the surface is smooth. Slow growth, when the lesion range is small, often no obvious symptoms. When the tumor is large, it can protrude to the pharynx, so that the pharyngeal wall is moved and full, and when it is severe, it can affect the breathing. Occasionally, it can be malignant, manifested as a rapid increase in tumors in the short term, or with signs of vagus, hypolingual nerve palsy.
Examine
Neurogenic tumor examination
1. Detailed medical history including age, gender, length of disease, severity of symptoms, treatment effect, and clinical manifestations of organ involvement such as nose, pharynx, larynx, and oral cavity, or systemic symptoms such as fever and weight loss.
2, clinical examination first pay attention to observe whether the neck on both sides is symmetrical, with or without local swelling, fistula formation and other phenomena. Then the neck is diagnosed. At the time of examination, the subject's head is slightly lower, and the side of the patient is inclined to relax the neck muscles, which is convenient for the bumps. Pay attention to the location, size, texture, activity, presence or absence of tenderness or pulsation of the mass, and compare it with the two sides. As mentioned above, adult neck masses should consider metastatic malignant tumors. Therefore, routine examination of the ear, nose, throat, mouth, etc., in order to understand the presence or absence of primary lesions in the nasopharynx, throat, etc. Endoscopic or fibrous nasopharyngoscopy can be performed if necessary.
3, imaging examination of the neck CT scan in addition to understanding the location and extent of the tumor, and help to identify the relationship between the mass and the carotid artery, internal jugular vein and other important structures, provide an important reference for surgical treatment, but a smaller mass , often can not be developed. In order to find the primary lesion, X-ray film examinations such as sinus, nasopharynx and larynx can be performed as appropriate. For the neck split fistula or thyroglossal fistula, it is feasible to check the X-ray film of the iodized oil to understand the direction and extent of the fistula.
4, pathological examination (1) biopsy method: a small needle into the mass, the tissue obtained after forced aspiration, cytopathological examination. Applicable to most neck lumps, but the tissue obtained is less. When the test is negative, it should be combined with clinical examination for further examination. (2) Cut biopsy: it should be used with caution. Generally only when the diagnosis is not confirmed after repeated examinations. A single lymph node should be removed completely during surgery to prevent the spread of the lesion. When suspected tuberculous cervical lymphadenitis, after the biopsy is cut, it may lead to long-term failure of the wound, and attention should be paid to prevention. For patients with clinically diagnosed parotid-derived or neurogenic benign tumors, due to the deep tumor location, preoperative biopsy is not easy to obtain positive results, but it has the disadvantage of making the tumor adhere to surrounding tissues and increasing the difficulty of surgery. Pathological examination was performed after surgical removal of the tumor.
Diagnosis
Diagnosis and diagnosis of neurogenic tumors
For schwannomas, Schwann cells originating from the cerebral sheath often occur in the neck cutaneous nerve, sympathetic nerve, vagus nerve and so on. The tumor is located in the upper part of the lateral aspect of the neck, deep in the sternocleidomastoid muscle. With a round or round shape, the surface is smooth. Slow growth, when the lesion range is small, often no obvious symptoms. When the tumor is large, it can protrude to the pharynx, so that the pharyngeal wall is moved and full, and when it is severe, it can affect the breathing. Occasionally, it can be malignant, manifested as a rapid increase in tumors in the short term, or with signs of vagus, hypolingual nerve palsy.
