頸部迷走神経ノイリノーム—2症例報告ならびに文献的考察

NEUIRLEMMOMA OF THE CERVICAL VAGUS NERVE, REPORT OF TWO CASES WITH A COLLECTIVE REVIEW OF LITERATURE

　末梢神経由来の腫瘍は少ない。ことに迷走神経から発生したノイリノームは稀である。本邦では大正15年関口^1）による第1例の報告以来現在まで症例数は20例をこえていない。

　最近私どもは2例を経験し，外科的に剔出し治癒し得たので文献的に考察を加えて報告する。

　Tow cases of neurilemmoma of the vagus nerve in the cervical region are reported.

　The case 1. A woman, aged 48, complained of a gradual enlargement of a painless mass in the midportion of the left sternocleidomastoid muscle. The mass was surgically extirpated which revealed its apparent connection with the vagus nerve.The tumor, measuring 2.1×1.5×1.0cm, was found to be covered with a thin, gray connective tissue capsule. The anastomosis of the vagus nerve was performed ; however, the recurrent nerve paralysis is present.

　The case 2. A man, aged 26, complained of a painless mass in the lower portion of the right sternocleidomastoid muscle. A spasmodic cough was elicited by light manipulation of this mass. Clinical diagnosis was neurinoma of the vagus nerve. At surgery the mass was found to be arising from the vagus nerve. The tumor, well encapsulated measuring 5.5×3.6×3.0cm, was removed by sectioning the vagus nerve. Postoperative complication of the recurrent nerve paralysis is noted.

　The histological sections of the tumor in both cases proved to be neurilemmoma and demonstrated the presence of Antoni A and B types of cell patterns.

　Including the above two cases, nineteen cases of neurilemmoma of the vagus nerve of the neck have been found in the literature of this country. The tumor may occur at any age, particularly between 25 to 60 years, with no apparent predilection to sex. However, most of the reported cases have been in patients in the third to fifth decade of life. The average being 42 years ; the right vagus nerve was affected in comparison to the left in the ratio of 2:1.