ORIGINAL RESEARCH
Neurogenic Tumors of the Neck: A 20 Year Review
Boynun Nörojenik Tümörleri: 20 Yıllık Seri
Received Date : 29 Aug 2023
Accepted Date : 16 Oct 2023
Available Online : 26 Oct 2023
Ömer VURALa, Cem ÖZERb, Fulya ÖZERb, İsmail YILMAZb
aClinic of Otorhinolaryngology, Head and Neck Surgery, Bingöl State Hospital, Bingöl, Türkiye
bDepartment of Otorhinolaryngology, Head and Neck Surgery, Başkent University Adana Training and Research Center, Adana, Türkiye
Doi: 10.24179/kbbbbc.2023-99268 - Makale Dili: EN
Journal of Ear Nose Throat and Head Neck Surgery. 2024;32(1):30-6
Copyright © 2020 by Turkey Association of Society of Ear Nose Throat and Head Neck Surgery. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)
ABSTRACT
Objective: To investigate the clinical presentation, diagnostic
strategy, treatment approach, and postoperative morbidity of
neurogenic tumors in the neck region, which are rarely observed and
cannot be easily separated from other masses of this region. Material
and Methods: A retrospective analysis of the medical data of patients
with histopathologically confirmed neurogenic tumors who underwent
surgery at the otorhinolaryngology department over the 20 years from
2000 to 2019. Results: Twenty-one patients were evaluated. Fifteen
(71%) of them were women and 6 (29%) were men, with ages of 0-75
years. Out of 21 cases, 19 (90%) were benign, while 2 (10%) cases had
malignant histology. Of the patients, 14 (67%) were diagnosed with peripheral
nerve sheath tumors, 5 (24%) with ganglion cell tumors, and 2
(9%) with paraganglion cell tumors. The most common presentation
symptom was neck swelling. Other symptoms included pain and numbness
in the arm, dyspnea, dysphagia, and snoring. Postoperative morbidities
included Horner’s syndrome, vocal cord palsy, and motor
weakness of the upper limp. Fine‐needle aspiration cytology was not diagnostic
in any of the patients who underwent the procedure; core needle
biopsy was diagnostic in all patients who underwent. Conclusion:
Neurogenic tumors located in the neck are extremely rare. Differential
diagnoses of these tumors are critical to provide patients with information
about possible postoperative neurological deficits and other
morbidities. Neither imaging methods nor preoperative biopsies can
provide clear information about the definitive diagnosis.
Keywords: Neck; neurogenic tumor; neurinoma; schwannoma
ÖZET
Amaç: Bu çalışmanın amacı, boyun bölgesinde nadir görülen
ve bu bölgedeki diğer kitlelerden kolaylıkla ayrılamayan nörojenik tümörlerin
klinik tablosunu, tanı stratejisini, tedavi yaklaşımını ve postoperatif
morbiditesini araştırmaktır. Gereç ve Yöntemler: 2000
yılından 2019 yılına kadar 20 yıl boyunca kulak-burun-boğaz bölümünde
ameliyat edilen, histopatolojik olarak doğrulanmış nörojenik tümörleri
olan hastaların tıbbi verilerinin retrospektif analizi yapıldı.
Bulgular: Toplamda 21 hasta değerlendirildi. Yaşları 0-75 arasında
olan hastaların 15’i (%71) kadın, 6’sı (%29) erkekti. Yirmi bir olgunun
19’u (%90) benign, 2’si (%10) ise malign histolojiye sahipti. Hastaların
14’üne (%67) periferik sinir kılıfı tümörü, 5’ine (%24) ganglion
hücreli tümör, 2’sine (%9) paraganglion hücreli tümör tanısı konuldu.
En sık başvuru semptomu boyunda şişlikti. Diğer semptomlar; kolda
ağrı ve uyuşma, nefes darlığı, yutma güçlüğü ve horlamaydı. Ameliyat
sonrası morbiditeler arasında Horner sendromu, vokal kord paralizisi ve
üst ekstremitede motor güçsüzlük vardı. İnce iğne aspirasyon sitolojisi
uygulanan hastaların hiçbirinde tanısal değildi, kalın iğne biyopsisi yapılan
hastaların tamamında tanı koydurucuydu. Sonuç: Boyunda yerleşen
nörojenik tümörler son derece nadirdir. Bu tümörlerin ayırıcı
tanısı hastalara postoperatif olası nörolojik defisitler ve diğer morbiditeler
hakkında bilgi verilmesi açısından oldukça önemlidir. Ne görüntüleme
yöntemleri ne de ameliyat öncesi biyopsiler kesin tanı
konusunda net bilgi verememektedir.
Anahtar Kelimeler: Boyun; nörojenik tümör; nörinoma; şıvannoma
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