A CLINICAL STUDY OF NEURILEMMOMA IN THE HEAD AND NECK

Abstract

There were sixteen cases of neurilemmoma in the head and neck, which were observed at Kanazawa University Hospital from 1973 to 1985. In ou r series, the tumor was distributed as follows: nasal cavity, 4 cases; pharynx, 4 cases; pnrotid gland, 2 cases; oral cavity, 2 cases; mastoid, 1 case; auditory canal, 1 case; upper neck, 1 case and epiglottis, 1 case. All cases were treated with surgical excision. In a case of pharynx, part of the tumor remained because the capsule was indistinguishable, and has recurred after 5 years. In the histological findings, uncapsulated tumors were found in the cases of the nasal cavity and epiglottis. Some cases of the nasal cavity have lacked the capsule on the surface of the tumor facing to open space. Two tumors of the pharynx and upper neck had their origin from sympathetic nerve in the parapharyngeal space. According to CT scan, tumors arising from the sympathetic nerve had appeared in the anterior part of parapharyngeal space or posterior part (carotid sheath) of it. Thus we supposed that neurilemmoma arised from the sympathetic nerve would be classified into three groups; pharyngeal type which corresponds to pharyngeal tumor, carotid sheath type which corresponds to upper neck tumor and mixed type which extends to both region. It is significant to foreknow the relation of carotid and jugular vein to tumor, especially in the carotid sheath type, preoperatively. For this reason, CT scan with contrast enhancement would be prefered.