RESUMO
A 40-year-old woman presented with insidious onset, gradually progressive dysarthria and inability to manoeuvre bolus of food in her mouth while eating. The duration of her symptoms was 3 months. On evaluation, the left half of her tongue was wasted. The tongue deviated to the left on protrusion. There were no clinical features suggestive of involvement of the ipsilateral 9th, 10th or 11th cranial nerves. MRI of the brain showed a large, fusiform lesion in the left hypoglossal canal, extending into the jugular canal. The lesion was surgically excised and found to be a schwannoma.
Assuntos
Doenças dos Nervos Cranianos/patologia , Doenças do Nervo Hipoglosso/patologia , Nervo Hipoglosso/patologia , Neurilemoma/patologia , Adulto , Doenças dos Nervos Cranianos/etiologia , Diagnóstico Diferencial , Disartria/diagnóstico , Disartria/etiologia , Feminino , Humanos , Doenças do Nervo Hipoglosso/complicações , Laringoscopia/métodos , Imageamento por Ressonância Magnética/métodos , Neurilemoma/complicações , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Língua/patologia , Doenças da Língua/patologia , Resultado do TratamentoRESUMO
The authors present the case of a middle-aged woman diagnosed with lobar carcinoma in situ in her right breast. She eventually underwent a mastectomy and reconstruction. Histology revealed grade II invasive ductal carcinoma and she was commenced on adjuvant letrozole. The following year a MRI scan revealed she had developed spinal metastases and CT confirmed the presence of liver and lung metastases. She presented with a 5-month history of tongue weakness and difficulty manipulating food to the back of her mouth. On examination, there was marked right-sided hemiatrophy of the tongue with deviation of the tongue to the right side upon protrusion. MRI demonstrated ill-defined enhancing material close to the intracranial opening of the right hypoglossal canal. The patient was referred for consideration of radiotherapy. Due to the comorbidities of the patient, she was not a candidate for neurosurgical intervention.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Lobular/secundário , Doenças do Nervo Hipoglosso/etiologia , Recidiva Local de Neoplasia/cirurgia , Neoplasias Primárias Múltiplas/patologia , Neoplasias da Mama/cirurgia , Carcinoma Lobular/cirurgia , Progressão da Doença , Feminino , Seguimentos , Humanos , Doenças do Nervo Hipoglosso/patologia , Doenças do Nervo Hipoglosso/terapia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Imageamento por Ressonância Magnética/métodos , Mamoplastia , Mastectomia/métodos , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Neoplasias Primárias Múltiplas/cirurgia , Medição de RiscoRESUMO
"Ancient schwannomas" of the mouth floor are rare, benign neoplasms derived from the nerve sheath of peripheral nerves. They show many degenerative changes such as necrosis and vascular thrombosis. Ancient schwannomas show histopathological features, such as degenerative changes and atypical nuclei, and may easily be confused with malignant neoplasms. B-scan sonography for the mouth floor and MRT imaging may be helpful in differential diagnosis. Here, we report on a patient with ancient schwannoma of the floor of the mouth.