Kubo T, Nakamura H, Yamano Y
Department of Orthopaedic Surgery, Osaka City University Medical School, Osaka, Japan.
J Spinal Disord. 2001 Feb;14(1):79-83. doi: 10.1097/00002517-200102000-00013.
Neurogenic dumbbell tumors occur more frequently in the cervical than in the thoracic or lumbar spine. Cervical paravertebral masses usually do not become exceptionally large because they are superficial and are palpated easily. Thoracic tumors can become large before they are detected. The authors describe a large intrathoracic dumbbell tumor arising from the C8 nerve root. The intraspinal tumor was resected through a posterior approach. In the second stage, dividing the clavicle, the intrathoracic component was resected by separating it from the lung. Two years after treatment, the preoperative neurologic deficit had improved except for weakness of muscles innervated by the C8 nerve root. Radiographs showed no residual or recurrent mass at the apex of the lung. Sometimes a retroclavicular location may conceal a large paravertebral mass, such as Pancoast tumors. As described here, the transclavicular approach gave adequate access to the cervicothoracic junction.
神经源性哑铃状肿瘤在颈椎比在胸椎或腰椎更常见。颈椎旁肿块通常不会变得特别大，因为它们位置表浅，容易触及。胸部肿瘤在被发现之前可能会变大。作者描述了一例起源于C8神经根的巨大胸内哑铃状肿瘤。经后路切除椎管内肿瘤。在第二阶段，通过切开锁骨，将胸内部分与肺分离后切除。治疗两年后，除了由C8神经根支配的肌肉无力外，术前神经功能缺损有所改善。X线片显示肺尖无残留或复发肿块。有时锁骨后位置可能会掩盖一个大的椎旁肿块，如潘科斯特瘤。如此处所述，经锁骨入路可充分显露颈胸交界处。
