がく下部に発生した神経しょうしゅの１例

Abstract

Neurinoma is known to be a relatively rare disease especially in the regions of the jaw and the oral cavity. Mostly it emerges from the tongue, the buccal mucous membrane and the palate. Recently the authors experienced a case where this disease developed from the lower part of the jaw of an elderly woman of age 76. This case is reported below, together with its clinical and documentary discussions.The patient is a female aged 76. She had a chief complaint of swelling in the lower part of the jaw. Clinical observation revealed tumefaction of a size larger than a chiken egg in the left, lower part of the jaw. On palpation, a phyma was felt, which was movable and of relatively clear boundary. It was elastic and soft. The patient had no tenderness on pressure nor spontaneous pain. Based on the clinical diagnosis of a phyma in the lower part of the jaw, an enucleation was carried out under general anesthesia November 2, 1984. The phyma had a cover of a thin film, with no accretion of surrounding tissues. It was enucleated easily as a lump. The 40×28×22mm phyma was egg-like in shape, smooth surfaced, dark brown, soft and elastic was grayish yellow or grayish white in the divided surface.The inside of the phyma was filled with a bloody fluid. According to our histopathological findings, the phyma had a typical shelf-like arrangement.The disease was diagnosed as neurinoma (Antoni Type A). Although it is reported that this disease is infrequently recurrent and prognostically good, careful attention will be paid to the prognosis of this patient.