Cov qog nqaij hlav puas tuaj yeem loj hlob ntawm koj cov hlab ntsha? Cia peb tham txog Nerve Sheath Tumors hauv cov lus yooj yim!

Cov hlab ntsha uas khiav thoob plaws peb lub cev zoo li ib lub network ntawm cov xov hlau uas nqa cov lus hluav taws xob. Lawv yog cov uas nqa cov ntaub ntawv rov qab los ntawm lub hlwb mus rau lwm qhov ntawm lub cev, thiab los ntawm lub cev mus rau lub hlwb. Xav txog tias cov hlwb hlab ntsha no, lawv cov pawg, txhua tus tau qhwv rau hauv cov ntaub thaiv tshwj xeeb, zoo li lub hnab yas nyob ib puag ncig ib lub xov hlau, los tiv thaiv lawv thiab pab cov teeb liab hluav taws xob mus tau sai dua. Nws yog nyob rau hauv cov ntaub thaiv tiv thaiv no uas cov qog nqaij hlav hu ua cov hlab ntsha no qee zaum tshwm sim.

Cov Nerve Sheath Tumors yog dab tsi?

Hais yooj yim xwb, cov qog no tsim nyob rau hauv cov "sheaths" tiv thaiv uas nyob ib puag ncig peb cov hlab ntsha. Cov "sheath" lossis daim npog no muaj ntau txheej:

• Cov hlwb Schwann: Cov no yog cov hlwb uas qhwv ib ncig ntawm lub axon, qhov ntev ntawm cov hlab ntsha, zoo li cov rwb thaiv tsev nyob ib ncig ntawm ib txoj hlau.
• Endoneurium: Qhov no yog cov ntaub so ntswg sib txuas uas nyob ib puag ncig txhua lub paj hlwb, zoo li lub plhaub nyob ib puag ncig ib txoj hlau tooj liab hauv ib txoj hlau.
• Perineurium: Qhov no yog qhov uas nyob ib puag ncig cov pob ntawm cov hlab ntsha.

Peb lub paj hlwb muaj ob ntu:

• Lub paj hlwb nruab nrab: Qhov no suav nrog peb lub hlwb thiab tus txha caj qaum.
• Peripheral nervous system: Qhov no yog lub network ntawm cov hlab ntsha uas ceg tawm ntawm lub hlwb thiab tus txha caj qaum mus rau txhua qhov ntawm lub cev.

Feem ntau, cov neurofibromas no tsim nyob rau hauv lub paj hlwb peripheral .

Muaj hom txiv ntoo dab tsi?

Muaj ntau hom neuromas tseem ceeb. Cia peb saib seb lawv yog dab tsi.

Schwannomas

Cov qog no loj hlob hauv cov hlwb Schwann uas tau hais ua ntej. Kwv yees li 60% ntawm cov schwannomas loj hlob hauv cov hlab ntsha vestibular hauv peb lub pob ntseg sab hauv . Cov hlab ntsha no pab peb lub cev tswj kev sib npaug. Lwm cov schwannomas qee zaum tuaj yeem loj hlob hauv qab peb daim tawv nqaij, lossis tob hauv cov nqaij thiab cov kabmob ntawm lub cev. Cov chaw feem ntau uas pom cov qog no yog:

• Hauv caj npab thiab ceg
• Hauv lub taub hau
• Hauv lub cev (uas yog, thaj chaw ntawm lub xub pwg nyom thiab lub duav)

Schwannomas yog ib hom qog nqaij hlav uas feem ntau npog los ntawm ib txheej nyias nyias ntawm cov ntaub so ntswg, lossis "encapsulated." Cov qog nqaij hlav no feem ntau tsis yog mob qog nqaij hlav (benign). Txawm li cas los xij, tsis tshua muaj, cov qog nqaij hlav uas nyob ntev tuaj yeem dhau los ua mob qog nqaij hlav (malignant).

Neurofibromas

Hom qog no muaj ntau hom nqaij hu ua Schwann cells, endoneurium, thiab perineurium uas npog cov hlab ntsha. Feem ntau cov no zoo li cov qog hauv qab daim tawv nqaij, tab sis qee zaum tuaj yeem loj hlob ntawm cov hlab ntsha tob hauv lub cev.

Tsis zoo li cov schwannomas, cov neurofibromas tsis tau muab ntim rau hauv lub hnab. Lawv loj hlob hauv cov hlab ntsha. Plexiform neurofibromas yog ib hom qog uas nthuav dav zoo li lub mesh, nyob ib puag ncig ntau cov hlab ntsha thiab tuaj yeem nthuav dav mus rau hauv cov ntaub so ntswg ib puag ncig.

Feem ntau cov neurofibromas tsis yog mob qog noj ntshav. Txawm li cas los xij, kwv yees li 5% txog 10% ntawm cov qog no tuaj yeem dhau los ua mob qog noj ntshav . Lawv hu ua malignant peripheral nerve sheath tumors (MPNST) . Kwv yees li ib nrab ntawm cov neeg uas muaj cov qog no twb tau kis mus rau lwm qhov ntawm lub cev thaum lawv raug kuaj pom.

Cov txiv no muaj ntau npaum li cas?

Cov qog nqaij hlav ntawm cov hlab ntsha uas tsis yog mob qog noj ntshav yog qhov tsawg heev.

• Schwannomas feem ntau pom muaj nyob rau hauv cov neeg hnub nyoog ntawm 50 thiab 60 xyoo.
• Neurofibromas feem ntau tshwm sim rau cov neeg hnub nyoog ntawm 20 thiab 40 xyoo.
• Feem ntau cov Plexiform neurofibromas tshwm sim ua ntej hnub nyoog 5 xyoos.

Cov qog nqaij hlav ntawm cov hlab ntsha loj (malignant Peripheral Nerve Sheath Tumors) yog ib hom qog nqaij hlav tsis tshua muaj , tsuas yog cuam tshuam txog ib tus ntawm 10 lab tus tib neeg txhua xyoo.

Vim li cas cov qog nqaij hlav thiaj li zoo li no? Dab tsi yog cov ua rau muaj qhov no?

Kev hloov pauv caj ces muaj feem cuam tshuam loj rau kev loj hlob ntawm cov neurofibromas no.

• Kev loj hlob ntawm Schwannomas yog txuam nrog kev hloov pauv hauv cov noob hu ua NF2.
• Neurofibromas muaj feem cuam tshuam nrog ib lub noob hu ua (NF1).

Feem ntau, cov kev hloov pauv caj ces no tshwm sim tsis tu ncua, tsis muaj qhov ua rau pom tseeb . Txawm li cas los xij, muaj ob peb tug schwannomas thiab neurofibromas yog tshwm sim los ntawm ib qho mob caj ces tsis tshua muaj hu ua neurofibromatosis , uas tuaj yeem tshwm sim hauv tsev neeg.

Cov Hom Mob Neurofibromatosis

Muaj peb hom kab mob no tseem ceeb:

• Kab mob Neurofibromatosis hom 1 (NF1): Cov neeg uas muaj NF1 yuav muaj ntau cov neurofibromas. Lawv kuj muaj feem yuav muaj cov plexiform neuromas thiab cov qog nqaij hlav malignant peripheral nerve sheath (MPNST). Lwm yam mob uas pom muaj nyob rau hauv cov neeg uas muaj NF1 suav nrog macrocephaly , scoliosis, thiab kev kawm tsis tau zoo .

• Kab mob Neurofibromatosis hom 2 (NF2):Yuav luag txhua tus neeg uas muaj NF2 muaj cov pob ntseg vestibular schwannomas hauv ob lub pob ntseg ua ntej hnub nyoog 30 xyoo. Tsis tas li ntawd xwb, lwm hom schwannomas thiab qog nqaij hlav kuj tuaj yeem tshwm sim hauv lawv daim tawv nqaij, qhov muag, thiab lub paj hlwb hauv nruab nrab.

• Schwannomatosis: Hauv qhov mob no, ntau yam schwannomas tsim nyob rau hauv cov hlab ntsha vestibular (hauv ob lub pob ntseg) es tsis yog nyob rau hauv cov hlab ntsha vestibular.

Cov tsos mob ntawm cov qog no yog dab tsi?

Feem ntau cov neeg uas muaj cov qog neuromastoid tsis hnov ​​mob lossis lwm yam tsos mob . Txawm li cas los xij, yog tias cov qog loj hlob lossis nias rau ntawm cov hlab ntsha, cov tsos mob xws li:

• Ib lub pob los yog qog nqaij hlav hauv qab daim tawv nqaij (tej zaum yuav mob thaum nias).
• Cov leeg tsis muaj zog .
• Kev tsis muaj zog .
• Mob nqaij, mob nqaij, los yog mob hnyav .
• Ib qho kev xav tingling, zoo li raug ntaus los ntawm hluav taws xob .

Nyob ntawm seb qhov mob qog nyob qhov twg, tej zaum yuav muaj lwm yam tsos mob tshwj xeeb tshwm sim. Nov yog ob peb yam piv txwv:

• Ib qho qog ntawm cov hlab ntsha sciatic: Qhov mob uas kis mus los ntawm nraub qaum mus rau ceg (sciatica).
• Ib qho qog ntawm lub dab teg: Cov tsos mob zoo ib yam li cov tsos mob ntawm Carpal Tunnel Syndrome.
• Mob qog ntawm cov hlab ntsha vestibular: Tsis hnov ​​​​lus zoo, tinnitus, thiab teeb meem sib npaug.

Feem ntau, yog tias ib tug neeg muaj tus mob neurofibromatosis, nws yog ib lub qog xwb. Txawm li cas los xij, rau cov neeg uas muaj tus mob neurofibromatosis uas tau hais ua ntej lawm, ntau lub qog yuav pom tau (feem ntau ntawm daim tawv nqaij).

Koj paub li cas tias koj muaj cov txiv ntoo no?

Koj tus kws kho mob yuav xub kuaj koj lub cev thiab soj ntsuam koj txoj kev noj qab haus huv tag nrho. Qhov no yuav suav nrog kev nug txog koj keeb kwm kev mob nkeeg, keeb kwm kev mob nkeeg hauv tsev neeg, thiab tej yam tsos mob uas koj muaj.

Yog xav tshawb xyuas ntxiv txog qhov mob qog uas twb pom lawm lossis qhov mob qog uas xav tias muaj, koj tus kws kho mob yuav pom zoo kom ua cov kev kuaj mob no:

• Kev kuaj duab kho mob: Cov no suav nrog MRI scans, ultrasound scans, thiab PET scans kom pom qhov mob qog kom meej.
• Kev kuaj mob: Yuav muab ib daim nqaij me me ntawm lub qog thiab kuaj hauv lub tshuab microscope kom paub seb muaj hom cell twg. Qhov no yuav qhia tau rau koj paub tseeb tias lub qog puas yog mob qog noj ntshav lossis tsis yog.

Yog tias koj muaj ntau yam qog nqaij hlav, koj tus kws kho mob kuj tseem yuav pom zoo kom kuaj cov noob caj noob ces kom pom tias koj puas muaj cov mob hu ua (NF1), (NF2), thiab Schwannomatosis.

Cov kev kho mob rau qhov no yog dab tsi?

Yog tias koj tsis muaj tsos mob los ntawm neuromastoid, koj tus kws kho mob yuav pom zoo kom "saib thiab tos."Koj siv tau txoj kev hu ua "kev saib xyuas." Qhov ntawd txhais tau tias yuav tsum kuaj xyuas lub qog tsis tu ncua kom pom tias nws loj dua lossis hloov pauv.

Rau cov qog nqaij hlav uas muaj tsos mob, lossis yog tias koj xav tshem tawm cov qog nqaij hlav vim yog qhov zoo nkauj, kev phais feem ntau yog tib txoj kev xaiv xwb .

Qee cov neurofibromas, tshwj xeeb tshaj yog cov hu ua plexiform neurofibromas, nyuaj rau tshem tawm tag nrho vim tias lawv loj hlob sab hauv cov hlab ntsha thiab ntawm cov txheej ntawm daim ntaub npog. Yog tias cov qog tsis tuaj yeem tshem tawm tag nrho tom qab phais, koj tus kws kho mob yuav saib xyuas koj ze, vim tias cov qog tuaj yeem loj hlob rov qab.

Kev kho mob schwannomas hauv lub taub hau

Cov kab mob Schwannomas uas tsim nyob rau hauv lub taub hau, xws li cov kab mob vestibular schwannomas, tuaj yeem cuam tshuam rau cov hlab ntsha uas tswj cov haujlwm tseem ceeb hauv peb lub cev. Hauv cov xwm txheej no, cov kws kho mob siv cov txheej txheem hu ua stereotactic radiosurgery (piv txwv li, Gamma Knife®) los tiv thaiv kev puas tsuaj rau cov hlab ntsha.

Qhov no tsis yog ib txoj kev phais mob ib txwm uas yuav tsum tau phais. Nws yuav tsum tau xa ib txoj kab hluav taws xob uas raug tsom mus rau ntawm daim tawv nqaij kom rhuav tshem lossis ua rau lub qog me dua.

Kev kho mob ntawm cov qog nqaij hlav peripheral nerve sheath cancer

Ntxiv rau kev phais mob, kev kho mob qog noj ntshav xws li kev kho hluav taws xob thiab chemotherapy kuj tseem siv tau los kho cov qog nqaij hlav malignant peripheral nerve sheath.

Tej yam teeb meem uas yuav tshwm sim los ntawm kev phais yog dab tsi?

Ib yam li kev phais mob, muaj ntau yam teeb meem uas tshwm sim nrog cov kev phais mob no:

• Los ntshav
• Kev kis mob ntawm qhov txhab
• Mob
• Kev ua kom mob

Tsis tas li ntawd xwb, kev phais mob hlab ntsha muaj kev pheej hmoo ntawm kev puas tsuaj rau hlab ntsha thiab kev tsis taus mus tas li . Koj pab neeg kho mob yuav pab koj tswj hwm txhua qhov kev tsis taus mus sij hawm ntev uas yuav tshwm sim tom qab phais. Ntau yam kev kho mob (kev kho lub cev, kev kho mob ua haujlwm, thiab kev kho kev hais lus) yuav pab koj rov zoo.

Puas tiv thaiv tau cov qog no kom tsis txhob loj hlob?

Tsis muaj ib txoj kev uas paub tias yuav tiv thaiv cov qog no kom tsis txhob loj hlob. Txawm li cas los xij, koj tus kws kho mob yuav pom zoo kom kuaj cov noob caj noob ces yog tias koj:

• Yog tias leej twg hauv koj tsev neeg muaj keeb kwm ntawm kev tsim cov neurofibromas.
• Yog tias koj muaj ntau yam qog nqaij hlav ntawm cov hlab ntsha (qhov no yuav yog ib qho cim qhia txog tus mob neurofibromatosis).

Peb yuav tsum xav li cas txog cov txiv ntoo no mus tom ntej? (Outlook)

Feem ntau cov neurofibromas tsis yog mob qog noj ntshav . Lawv tuaj yeem kho tau los ntawm kev phais thiab tsis tshua rov qab los. Txawm li cas los xij, yog tias koj lub qog tsis tuaj yeem raug tshem tawm tag nrho los ntawm kev phais, koj yuav tsum tau nyob hauv kev saib xyuas ntawm kws kho mob.

Kwv yees li 3 ntawm 4 tus neeg uas tau txais kev kho mob rau vestibular schwannoma muaj peev xwm khaws lawv cov pob ntseg .

Qhov kev pheej hmoo ntawm cov qog nqaij hlav ntawm cov hlab ntsha ua rau mob qog noj ntshav yog qhov tsawg heev. Qhov kev pheej hmoo siab tshaj plaws yog rau cov neeg uas muaj tus mob (NF1) uas muaj Plexiform neurofibroma. Kev kwv yees rau cov qog nqaij hlav ntawm cov hlab ntsha malignant peripheral nerve sheath (MPNST) tsis zoo, tshwj xeeb tshaj yog tias cov qog nqaij hlav loj dua 2 ntiv tes. Tsawg dua ib nrab ntawm cov neeg uas muaj tus mob no muaj sia nyob tsib xyoos tom qab kuaj pom.

Thaum twg koj yuav tsum mus ntsib kws kho mob?

Yog koj pom ib lub pob nyob hauv qab koj daim tawv nqaij, lossis muaj cov tsos mob uas koj xav tias yuav yog neurofibromatosis , mus ntsib kws kho mob tam sim ntawd . Tsis tas li ntawd, qhia rau koj tus kws kho mob yog tias muaj leej twg hauv koj tsev neeg tau muaj cov qog no.

Cov Lus Xaus Kawg coj mus tsev

Nco ntsoov tias, feem ntau cov qog nqaij hlav neuroendocrine yog cov qog nqaij hlav benign, tsis yog mob qog nqaij hlav uas loj hlob qeeb qeeb . Yog tias koj tsis muaj tsos mob, koj tus kws kho mob yuav txiav txim siab saib koj xwb. Yog tias xav tau tshem tawm cov qog nqaij hlav, kev phais feem ntau yuav ua tiav zoo heev. Nws tsis tshua muaj teeb meem tshwm sim (xws li tsis tuaj yeem tshem tawm cov qog nqaij hlav tag nrho, cov hlab ntsha puas tsuaj) tshwm sim, lossis rau cov qog nqaij hlav hloov mus ua mob qog nqaij hlav. Koj tus kws kho mob yuav pab koj tsim txoj kev npaj kho mob thiab teem sijhawm rau kev kuaj mob yav tom ntej los pab koj tswj koj tus mob. Yog li ntawd, tsis txhob ntshai tham nrog koj tus kws kho mob txog txhua yam.

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