Cormio G, Colamaria A, Di Vagno G, De Tommasi A, Loverro G, Selvaggi L
Department of Gynaecologic Oncology, University of Bari, Italy.
Eur J Obstet Gynecol Reprod Biol. 2000 Mar;89(1):59-61. doi: 10.1016/s0301-2115(99)00165-7.
Spinal cord compression by epidural metastasis is considered an exceptional complication in patients with cervical carcinoma. We report three patients treated for a cervical carcinoma who developed epidural metastasis with spinal cord compression at 9, 25 and 48 months after primary treatment of the uterine malignancy. All patients had poorly-differentiated adenocarcinomas with lymphovascular space invasion, and two had lymph node metastasis. All patients underwent emergency decompressive laminectomy followed by radiotherapy and a partial recovery of the neurological function was achieved. In two patients the spinal cord was the only site of recurrent disease, whereas the other had lung and brain metastasis at the time of epidural involvement diagnosis. All three patients, however, died of disseminated disease. Surgical decompression followed by radiation therapy may result in a complete preservation of the neurologic functions in patients with spinal cord compression secondary to metastatic carcinoma of the uterine cervix. Considering the propensity for disseminated disease, long term survival might be achieved only with the use of effective chemotherapy.
硬膜外转移导致的脊髓压迫被认为是宫颈癌患者罕见的并发症。我们报告了3例宫颈癌患者，她们在子宫恶性肿瘤初次治疗后9个月、25个月和48个月发生了硬膜外转移并伴有脊髓压迫。所有患者均为低分化腺癌伴脉管间隙浸润，其中2例有淋巴结转移。所有患者均接受了急诊减压性椎板切除术，随后进行放疗，神经功能部分恢复。2例患者脊髓是复发疾病的唯一部位，而另1例患者在诊断硬膜外受累时已有肺和脑转移。然而，所有3例患者均死于播散性疾病。对于继发于子宫颈转移癌的脊髓压迫患者，手术减压后放疗可能会完全保留神经功能。考虑到疾病播散的倾向，只有使用有效的化疗才可能实现长期生存。
