Diagnosis and treatment for cervical neurilemmoma in 77 cases / 中国普通外科杂志

ABSTRACT

Objective To summarize the experience on clinical diagnosis and treatment for cervical neurilemmoma. Methods The clinical data of 77 cases of cervical neurilemmoma from 1976 to 2005 were retrospectively analyzed. Results The diagnosis was dependent on the anamnesis, clinical presentations, ultrasonography, CT and cytology of fine needle aspiration. Correct preoperative diagnosis was abtained in 51 cases (66. 2% ) , and the misdiagnosis rate was 33. 8% (26/77). All patients underwent surgical resection. The postoperative diagnosis was benign neurilemmoma by pathological examinations. The postoperative complications included recurrent laryngeal nerve injuries (6 cases) , Horner syndrome (4 cases) , tongue deviation (3 cases), neck pain or numbness (2 cases) and reffered pain in limb (1 case). Sixteen patients were followed up, and these symptomes disappeared after 3-11 months. Nerve dysfunction remained in 2 out of 3 patients in whom the vagus was wrongly amputated during the operation. Intraoperative inadvertent sympathetic nerve amputation caused permanent nerve dysfunction. Conclusion B-mode ultrasonography, CT and fine needle aspiration cytology are useful for the diagnosis of cervical neurilemmoma. Surgical resection is most effective among all available therapies.