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2.
BMJ Case Rep ; 14(10)2021 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-34706913

RESUMO

A 33-year-old woman was diagnosed with right recurrent laryngeal nerve (RLN) schwannoma. She presented with a long history of hoarseness, and only recently developed dysphagia. On physical examination, a mass was observed over the right cervical level IV. Endoscopic examination of the larynx showed that she had right unilateral vocal cord palsy. She successfully underwent transcervical resection of the tumour followed by injection laryngoplasty. This study discusses the presentation of the tumour, radiological findings, our working diagnosis and treatment options of RLN schwannoma.


Assuntos
Laringoplastia , Neurilemoma , Traumatismos do Nervo Laríngeo Recorrente , Paralisia das Pregas Vocais , Adulto , Feminino , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Nervo Laríngeo Recorrente , Paralisia das Pregas Vocais/etiologia , Paralisia das Pregas Vocais/cirurgia
3.
J Craniofac Surg ; 32(7): e670-e672, 2021 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705371

RESUMO

ABSTRACT: Skull base vagal nerve schwannoma (VNS) is relatively uncommon and poses a challenge to surgeons. Although schwannomas are benign and slowly growing neoplasms arising from Schwann cells, they may cause significant dysfunction by causing the surrounding structures compression or infiltrating vital structures such as the skull base, the orbit, and the cranial nerves. These tumors are resistant to radiotherapy and chemotherapy. Complete surgical removal is the optimal treatment modality, with recurrence being rare. The authors report a case of a 58-year-old man with an extensive VNS involving the left jugular foramen and parapharyngeal space. The clinical presentation, surgical management, and outcomes of VNS are discussed.


Assuntos
Neurilemoma , Neoplasias da Base do Crânio , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Base do Crânio , Neoplasias da Base do Crânio/diagnóstico por imagem , Neoplasias da Base do Crânio/cirurgia
4.
Optom Vis Sci ; 98(10): 1156-1159, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34629435

RESUMO

SIGNIFICANCE: Facial nerve schwannomas are rare tumors that are usually benign and relatively slow in their progression. Common symptoms include facial neuropathy, auditory deficiencies, and parotid masses. Because of slow progression, symptoms are often present for over a year before an appropriate diagnosis is made. PURPOSE: The purpose of this study was to present a case in which comprehensive dry eye assessments and management led to diagnosis of facial nerve shwannoma in a patient who had no presenting symptoms of auditory deficiencies or facial weakness. CASE REPORT: A 36-year-old woman presented for a contact lens examination with concerns of progressively worsening symptoms of irritation and dryness in her right eye that began 6 months earlier. Dry eye assessment visits and management strategies were implemented. Although this regimen was initially successful, symptoms returned after 7 months. At this visit, a new finding of incomplete blink in her right eye was manifested. Further in-office assessments revealed a weakened right orbicularis oculi and right frontalis muscle. These findings, combined with patient risk factors and no history of trauma, prompted MRI of the seventh nerve. Imaging revealed the presence of seventh nerve schwannoma, the location of which correlated with the geniculate ganglion and greater superficial petrosal nerve. This patient was later referred to a neurosurgeon, who assessed the risks and benefits of schwannoma removal. It was decided that the risks of the surgery outweighed the benefits, and regular MRI was scheduled for monitoring purposes. Appropriate management of the patient's chronic dry eye disease continues. CONCLUSIONS: Facial nerve schwannomas can and do present with no presenting subjective facial neuropathy symptoms aside from mild unilateral dry eye and can be detected with comprehensive dry eye management. This case may contribute to future minor adjustments in clinical practice guidelines for asymmetric dry eye assessments.


Assuntos
Neoplasias dos Nervos Cranianos , Síndromes do Olho Seco , Doenças do Nervo Facial , Neurilemoma , Adulto , Síndromes do Olho Seco/diagnóstico , Diagnóstico Precoce , Feminino , Humanos , Neurilemoma/diagnóstico , Neurilemoma/cirurgia
5.
J Clin Neurosci ; 93: 106-111, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34656232

RESUMO

BACKGROUND AND AIMS: Multinodular/plexiform schwannomas and neurofibromas of major nerves are rare: before surgery, differential diagnosis among these two uncommon variants is challenging. For both forms, surgical removal is recommended in case of progressive growth and worsening of neurological symptoms. Surgery has a higher risk of neurological damage than conventional schwannomas or neurofibromas. In literature, a comparison among these rare tumors is usually limited to the pathological aspect while specific surgical and clinical management indications are lacking. Cutaneous tumors of both forms arising from terminal peripheral nerves' branches might be treated by plastic surgeons while tumors of major nerves remain under neurosurgical competence. Here we report our recent neurosurgical experience on the matter, to furnish useful suggestions for the management of these tumors. METHOD: We analyzed the clinical, radiological, and pathological data in a consecutive case series of plexiform/multinodular nerve tumors operated at our institution in the last five years. RESULTS: In our series, neurofibroma type of plexiform tumors was more frequent than schwannoma type: two sporadic plexiform-multinodular schwannomas (patients 1, and 5) and three multinodular/plexiform Neurofibromatosis familial (Neurofibromatosis 1 / NF-1) (patients 2, 3, and 4). Surgery was complex when major nerves were involved. The early outcome appeared mostly related to the pre-surgical neurological conditions and histological grading. INTERPRETATION: Although sharing some features, multinodular-plexiform schwannomas and neurofibromas have consistent differences from the clinical, surgical and pathological points of view.


Assuntos
Neurilemoma , Neurofibroma , Neurofibromatoses , Neurofibromatose 1 , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neurofibroma/diagnóstico por imagem , Neurofibroma/cirurgia , Nervos Periféricos
6.
Sultan Qaboos Univ Med J ; 21(3): 477-480, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34522416

RESUMO

Schwannomas are typically benign tumours of the peripheral nerves. However, they seldom arise from the obturator nerve. We report a case of an uncommon swelling (2.5 × 3.5 cm) in a 65-year-old male cadaver, found during a routine dissection session for first Bachelor of Medicine and Surgery students in the Department of Anatomy, Kasturba Medical College, Manipal, India, in 2019. It was seen originating from the left obturator nerve in the pelvis at the level of the sacral promontory. Histopathological investigation revealed a schwannoma. The hypocellular tumour was arranged in a sweeping fascicle pattern with patches of myxoid degeneration. Obturator schwannomas, though rare, can exist in cadavers, as seen in the present case. Hence, it should be considered as a differential diagnosis for clinical cases of pelvic masses and eliminated only after thorough radiological examination. Knowledge about the existence of such schwannomas is therefore essential.


Assuntos
Neurilemoma , Nervo Obturador , Idoso , Diagnóstico Diferencial , Humanos , Masculino , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Pelve , Radiografia
7.
BMJ Case Rep ; 14(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34548292

RESUMO

Intraosseous schwannoma is extremely rare that it is not often considered among differential diagnosis for an osteolytic lesion, especially in long bones of the extremities. Amounting to less than 0.2% of all primary bone tumours and less than 200 cases reported so far, with only 3 cases involving the humerus, we hereby report the fourth case. In addition to its rarity, this was the only case of an intraosseous schwannoma involving the humerus bone which presented with a pathological fracture in a 45-year-old woman after sustaining a trivial trauma. Radiological examination revealed a geographic type of osteolytic lesion in distal shaft region of the left humerus. Only a histopathological examination helped in revealing and confirming the diagnosis of an intraosseous schwannoma. Treatment of the tumour with complete excision with bone graft reconstruction and osteosynthesis yields good results with very low risk of recurrence.


Assuntos
Neoplasias Ósseas , Neurilemoma , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Feminino , Humanos , Úmero/diagnóstico por imagem , Úmero/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Radiografia
9.
J Am Podiatr Med Assoc ; 111(4)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34478538

RESUMO

Subungual schwannoma is quite rare and often causes nail deformity and difficulty in wearing shoes. Complete tumor excision is the treatment of choice, and we advocate that restoring the nail appearance should be considered at the same time. We present the case of 43-year-old man with a big toe subungual schwannoma. We designed a zigzag incision method to excise the tumor and also corrected nail-bed deformity. The patient had a smooth recovery, and the nail plate regrew with a good appearance.


Assuntos
Hallux , Doenças da Unha , Neurilemoma , Adulto , Humanos , Masculino , Doenças da Unha/cirurgia , Unhas , Neurilemoma/complicações , Neurilemoma/cirurgia , Retalhos Cirúrgicos
10.
Artigo em Inglês | MEDLINE | ID: mdl-34535223

RESUMO

BACKGROUND AND OBJECTIVE: Vestibular schwannoma is a benign tumour that originates in the eighth cranial nerve. It is termed intralabyrinthine schwannoma (ILS) when it develops in the inner ear, this being a rare origin. We present our experience in the management of three patients with ILS. MATERIALS AND METHODS: The results of tumour excision and cochlear implantation were evaluated in three patients with ILS: two intracochlear schwannomas (ICS) and one intravestibular schwannoma (IVS). RESULTS: Prior to surgery, all patients presented progressive sensorineural hearing loss and tinnitus. Complete tumour resection and cochlear implantation was possible in all patients, with favourable hearing rehabilitation. CONCLUSIONS: The therapeutic approach will depend on tumour size, growth rate, degree of hearing loss and presence of vestibular symptoms. Cochlear implantation (CI) in patients with ILS is possible when the cochlear nerve is present and functional. CI in patients, whether or not preceded by tumour excision, is an option with good hearing results in selected patients.


Assuntos
Implante Coclear , Implantes Cocleares , Neurilemoma , Vestíbulo do Labirinto , Nervo Coclear , Humanos , Neurilemoma/cirurgia
11.
J Med Case Rep ; 15(1): 436, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34412684

RESUMO

BACKGROUND: In this report, we describe the first case in literature of a patient with multiple schwannomas of the marginal mandibular branch of the facial nerve. CASE PRESENTATION: A Caucasian patient presented with a sudden onset of left lower facial nerve palsy House-Brackmann score III for 1 month. Computed tomography imaging was performed to exclude a cerebral event and revealed multiple tumors within the left parotid gland. Duplex ultrasound and magnetic resonance imaging scans delineated multiple, hypoechoic tumors, round in shape and well defined without a hilar structure along the left mandible. For histological verification, a left-side partial parotidectomy and extirpation of an intraparotideal node was performed with use of a nerve-integrity monitor. Histomorphological analysis of the resected tissue revealed a benign schwannoma. Facial nerve function remained unchanged since the operation. The size of the nonresected tumors is currently monitored regularly by ultrasonography. Fibromatosis has been excluded. CONCLUSIONS: If multiple tumors occur in the parotid gland and the angle of the jaw, schwannomas need to be considered as a differential diagnosis. To plan the right diagnostic surgical intervention and prevent nerve damage, a thorough ultrasound examination is essential in preoperative diagnostic work-up for any suspicious lesion of the parotid gland and jaw region.


Assuntos
Neoplasias dos Nervos Cranianos , Doenças do Nervo Facial , Linfoma , Neurilemoma , Neoplasias dos Nervos Cranianos/diagnóstico por imagem , Neoplasias dos Nervos Cranianos/cirurgia , Nervo Facial/diagnóstico por imagem , Doenças do Nervo Facial/diagnóstico por imagem , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia
12.
Medicina (Kaunas) ; 57(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34357008

RESUMO

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.


Assuntos
Neurilemoma , Neoplasias Retroperitoneais , Neoplasias da Bexiga Urinária , Humanos , Linfonodos/diagnóstico por imagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia , Tomografia Computadorizada por Raios X , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/cirurgia
13.
J Laryngol Otol ; 135(10): 937-939, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34446116

RESUMO

BACKGROUND: Total rhinectomy is an invasive procedure that significantly impairs the intranasal turbulence, humidification and heating of inspired air. The use of uvulopalatopharyngoplasty for the treatment of sleep-disordered breathing disorders such as primary snoring and obstructive sleep apnoea has diminished over the past years because of the emergence of less invasive procedures and alternative therapeutic options. This clinical record presents the treatment of a long-term side effect of total rhinectomy using uvulopalatopharyngoplasty. CASE REPORT: In 1997, a 62-year-old male underwent total rhinectomy for a nasal schwannoma, followed by rehabilitation with a nasal prosthesis. Twenty-one years later, he presented with severe complaints of nasal blockage and breathing difficulties during both daytime and night-time. Clinical examination revealed no major anomalies besides significant velopharyngeal narrowing. Thus, in 2019, uvulopalatopharyngoplasty was performed to re-establish velopharyngeal patency. Hereafter, the symptoms of nasal blockage disappeared, resulting in an improved quality of life. CONCLUSION: Uvulopalatopharyngoplasty may prove useful to treat selected patients with daytime breathing difficulties due to velopharyngeal narrowing.


Assuntos
Obstrução Nasal/cirurgia , Procedimentos Cirúrgicos Nasais/efeitos adversos , Neurilemoma/cirurgia , Palato Mole/cirurgia , Faringe/cirurgia , Úvula/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Obstrução Nasal/etiologia , Neurilemoma/diagnóstico , Neurilemoma/reabilitação , Neoplasias Nasais/patologia , Palato Mole/patologia , Faringe/patologia , Próteses e Implantes/efeitos adversos , Qualidade de Vida , Procedimentos Cirúrgicos Reconstrutivos/métodos , Aderências Teciduais/cirurgia , Resultado do Tratamento , Úvula/patologia
14.
Ann R Coll Surg Engl ; 103(10): e314-e316, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34448654

RESUMO

We report an intracerebral schwannoma originating in the angular gyrus of a 20-year-old female that was incidentally diagnosed after she presented with a post-traumatic seizure. After comprehensive investigations, including functional magnetic resonance imaging, she underwent a computed tomography-guided stereotactic resection of the lesion. Pathological examination confirmed features of a schwannoma. After six years of follow-up, she remains well, without any evidence of recurrence. Intracerebral schwannomas are extremely uncommon: fewer than 90 cases have been reported. We present a comprehensive summary of the literature and a discussion of novel theories on the pathogenesis of intracerebral schwannomas.


Assuntos
Neoplasias Encefálicas/diagnóstico , Neurilemoma/diagnóstico , Lobo Parietal , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Imageamento por Ressonância Magnética , Neurilemoma/diagnóstico por imagem , Neurilemoma/patologia , Neurilemoma/cirurgia , Neuroimagem , Lobo Parietal/diagnóstico por imagem , Lobo Parietal/patologia , Lobo Parietal/cirurgia , Radiocirurgia , Tomografia Computadorizada por Raios X , Adulto Jovem
15.
BMC Res Notes ; 14(1): 278, 2021 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-34289875

RESUMO

OBJECTIVE: Mediastinal schwannomas are sometimes confused with other neoplasms during initial radiological studies, especially when there is a history of cancer in another area. In these cases, a more accurate analysis using computed tomography (CT) or even magnetic resonance (MRI) is required. Our study aimed to perform a retrospective analysis of the clinical and imaging features for a series of patients with mediastinal schwannomas that were confirmed by histology and immunohistochemistry. RESULTS: We found eight patients, five men and three women, with an average age of 51 years for this study. The main signs and symptoms at diagnosis were chest pain, dyspnea, cough, and dysphagia. CT showed that the tumor was located in the posterior compartment of the chest in 7/8 cases. Tumors > 10 cm were more heterogeneous and showed cystic changes. All patients underwent posterolateral thoracotomy, and radiological follow-up showed no evidence of recurrence. Histological analysis was considered the gold standard to confirm diagnosis, along with at least one neurogenic IHC marker. In conclusion, mediastinal schwannomas are benign encapsulated tumors. According to CT, schwannomas > 10 cm show cystic degeneration more frequently. Posterolateral thoracotomy allows complete resection and is considered the surgical approach of choice.


Assuntos
Neoplasias do Mediastino , Neurilemoma , Feminino , Humanos , Masculino , Neoplasias do Mediastino/diagnóstico por imagem , Neoplasias do Mediastino/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Estudos Retrospectivos , Toracotomia
17.
BMJ Case Rep ; 14(7)2021 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-34285030

RESUMO

A 57-year-old man was incidentally diagnosed with a 7 cm left-sided retroperitoneal mass. The mass was presumed to be arising from the left adrenal gland on a CT scan of the adrenal glands. Thus, a thorough workup ensued, looking into the possible functionality of the lesion. All investigations resulted in the negative. Subsequently, the patient was referred for surgery to fully characterise the tumour. Histology proved that the lesion was a benign retroperitoneal schwannoma with no relation to the adrenal gland.


Assuntos
Neoplasias das Glândulas Suprarrenais , Neurilemoma , Neoplasias Retroperitoneais , Neoplasias das Glândulas Suprarrenais/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neoplasias Retroperitoneais/diagnóstico por imagem , Neoplasias Retroperitoneais/cirurgia
18.
World J Gastroenterol ; 27(25): 3940-3947, 2021 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-34321856

RESUMO

BACKGROUND: Schwannomas, also known as neurinomas, are tumors that derive from Schwann cells. Gastrointestinal schwannomas are extremely rare, but the stomach is the most common site. Gastric schwannomas are usually asymptomatic. Endoscopy and imaging modalities might offer useful preliminary diagnostic information. However, to diagnose schwannoma, the immunohistochemical positivity for S-100 protein is essential, whereas CD117, CD34, SMA, desmin, and DOG-1 are negative. CASE SUMMARY: A 45-year-old female was found to have a gastric mass during a medical examination, which was diagnosed as a gastric schwannoma. We performed endoscopic full-thickness resection and endoscopic purse-string suture. Pathology and immunohistochemical staining confirmed the diagnosis of gastric schwannoma through the positivity of S-100 protein. Furthermore, to exclude the misdiagnosis of gastrointestinal stromal tumor, we performed a mutational detection of the c-Kit and PDGFRA genes. Postoperative follow-up revealed that the patient recovered well. CONCLUSION: Immunohistochemical staining is essential for the diagnosis of schwannoma. Endoscopic full-thickness resection is an effective treatment method for gastric schwannoma.


Assuntos
Tumores do Estroma Gastrointestinal , Neurilemoma , Neoplasias Gástricas , Feminino , Gastroscopia , Humanos , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/cirurgia , Suturas
19.
BMJ Case Rep ; 14(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34281943

RESUMO

Head and neck schwannomas are a rare form of tumour arising from the nerve sheath. They are often slow growing and asymptomatic, posing a diagnostic challenge for clinicians. The great auricular nerve (GAN) provides cutaneous innervation to the lower pinna, ear lobule and the inferior periauricular area. Hence, surgical management of GAN schwannomas can have sensory and functional dysfunction postoperatively, necessitating good counselling and communication with the patient. We present the first documented case of GAN schwannoma in the West, with literature review and considerations for surgical management.


Assuntos
Pavilhão Auricular , Neurilemoma , Plexo Cervical , Pavilhão Auricular/cirurgia , Cabeça , Humanos , Pescoço , Neurilemoma/diagnóstico por imagem , Neurilemoma/cirurgia
20.
Neurol Med Chir (Tokyo) ; 61(10): 591-597, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34321383

RESUMO

Schwannomas of the trochlear nerve are relatively rare, and most patients present with preoperative diplopia because of trochlear nerve palsy. We describe the case of a 61-year-old male patient with a trochlear nerve schwannoma and no pre- and postoperative diplopia, despite his trochlear nerve being cut during the operation. We aimed to investigate the frequency of postoperative diplopia associated with intraoperative trochlear nerve disturbance by reviewing previous case reports, wherein postoperative diplopia did not occur after the trochlear nerve was cut intraoperatively. We recorded the frequency of diplopia because of intraoperative trochlear nerve disturbance, such as the trochlear nerve being cut, in cases without pre- and postoperative diplopia. We searched the PubMed, Medline, and Google Scholar databases for works published from 1976 to 2020 and followed the preferred reporting items for systematic reviews and meta-analyses guidelines. We reviewed 36 publications and found 92 cases of trochlear nerve schwannoma. Surgical resection was performed for 43 patients, of whom 40 were kept under observation and 9 were treated with radiation therapy. Of the 43 cases, 9 without preoperative diplopia underwent gross total resection. We analyzed ten cases (including ours) without preoperative diplopia to check for postoperative diplopia. In total, four cases, including ours, did not display postoperative diplopia despite the trochlear nerve being cut. This may be attributed to the preoperatively acquired motor and sensory fusion in the patient's vision because of tumor progression. Our findings may benefit neurosurgeons who treat patients with schwannomas and help them predict patients' outcomes.


Assuntos
Neoplasias dos Nervos Cranianos , Neurilemoma , Doenças do Nervo Troclear , Diplopia/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Neurilemoma/complicações , Neurilemoma/cirurgia , Nervo Troclear , Doenças do Nervo Troclear/complicações , Doenças do Nervo Troclear/cirurgia
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