本文選題：神經(jīng)鞘腫瘤 + 誤診��； 參考：《臨床誤診誤治》2016年12期

【摘要】：目的提高臨床醫(yī)生對惡性外周神經(jīng)鞘瘤(MPNST)的認識,減少誤診誤治。方法對我院收治并誤診為糖尿病足的MPNST 2例的臨床資料進行回顧性分析,并復習相關(guān)文獻。結(jié)果本文2例均因足部潰爛,發(fā)現(xiàn)血糖升高入院。最初在外院分別按足部皮膚軟組織感染、甲溝炎治療,效果差,后發(fā)現(xiàn)血糖高,予降糖治療,但創(chuàng)面仍遷延不愈。入院后行下肢血管彩色多普勒超聲(彩超)、肌電圖及心電圖等檢查發(fā)現(xiàn)患者無明顯糖尿病周圍血管及神經(jīng)病變,血糖控制良好,后行創(chuàng)面活體組織病理檢查(活檢)示S-100(+),確診為MPNST。1例拒絕進一步檢查及治療,要求出院,后失訪;1例經(jīng)淺表淋巴結(jié)及腹部、盆腔超聲、胸部及顱腦CT和全身骨掃描均未見異常,行截趾術(shù)切除病灶,后創(chuàng)面愈合出院。隨訪1年未訴不適。結(jié)論足部MPNST臨床少見,提高對該病的認識,盡早行活檢,爭取早診斷、早治療,對避免或減少誤診甚至誤治尤為重要。
[Abstract]:Objective to improve the understanding of malignant peripheral neurilemmoma (MPNST) by clinicians and to reduce misdiagnosis and mistreatment. Methods the clinical data of 2 cases of MPNST, which were misdiagnosed as diabetic foot, were reviewed and reviewed, and the results were reviewed in this paper. The results showed that the blood glucose increased in 2 cases due to foot ulceration. The effect of skin soft tissue infection and trench inflammation was poor, and the blood glucose was high and the blood sugar was found, but the wound still remained. After admission, the blood vessel color Doppler ultrasound (color Doppler ultrasound), electromyography and electrocardiogram found that the patients had no obvious diabetic peripheral vascular and deity lesions, the blood sugar was well controlled, and then the wound living tissue pathological examination was performed. Examination (biopsy) showed S-100 (+), confirmed MPNST.1 cases refused further examination and treatment, required discharge, and then lost visit. 1 cases of superficial lymph node and abdomen, pelvic ultrasound, chest and craniocerebral CT and bone scan were not abnormal, and the focus of the chest was removed, and the wound healed after 1 years. Conclusion foot MPNST is rare and improved. Conclusion foot MPNST is rare and improve clinical Early diagnosis, early diagnosis and early treatment are especially important for avoiding or reducing misdiagnosis and mistreatment.

【作者單位】： 解放軍空軍總醫(yī)院內(nèi)分泌科;
【分類號】：R739.4

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