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Case No. 272
2012-06-01~2012-06-30
출제자 : 김진아
Hit : 419
| Period | 2012-06-01~2012-06-30 |
|---|---|
| Diagnosis | Intraparotid schwannoma |
| Clinical information | 7세 남자, palpable mass for 6 months 진단은? |
| Discussion | Intraparotid schwannoma Schwannoma is an ectodermal benign encapsulated tumor arising from Schwann cells. Schwannomas of the facial nerve arise from either the extratemporal or intratemporal course of this nerve. Most of these tumors are intratemporal, whereas 9% are located extracranially and usually appear as an asymptomatic parotid mass. Hence, it is difficult to establish a correct preoperative diagnosis for facial nerve schwannoma in the parotid gland. It is important to suggest this diagnosis preoperatively because postoperative facial nerve paresis or palsy is common The main facial nerve trunk is centered just below the skull base near the stylomastoid foramen. And intraparotid facial nerve schwannomas are usually located in the posterolateral to the retromandibular vein and extend toward the stylomastoid foramen, consistent with the characteristic position of the facial nerve. Signal intensity is heterogeneous: iso signal intensity on T1- and iso to high signal intensity on T2-weighted images. Differential diagnoses include various benign or malignant salivary gland tumors such as pleomorphic adenoma and adenoid cystic carcinoma. References 1. Martin N, Sterkers O, Mompoint D, Nahum H. Facial nerve neuromas: MR imaging. Report of four cases. Neuroradiology 1992;34:62–67 2. Shimizu K, Iwai H, Ikeda K, Sakaida N, Sawada S. Intraparotid facial nerve schwannoma: a report of five cases and an analysis of MR imaging results. AJNR 2005;26:1328-1330 |
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