Yano Shunsuke, Hida Kazutoshi, Seki Toshitaka, Iwasaki Yoshinobu, Chouno Yoshimi, Sugimoto Shinji, Fujimoto Makoto, Nunomura Mitsuru
Department of Neurosurgery, Hokkaido University, Graduate School of Medicine, Japan.
No Shinkei Geka. 2002 Feb;30(2):189-96.
Intramedullary spinal cord metastasis was thought to be rare, but the advent of MR imaging and treatment for malignancy have revealed that it is more frequent than we previously thought. We report two cases of intramedullary spinal cord metastasis from lung and rectal colon carcinoma. Their symptoms were aggravated rapidly. We performed surgical treatment in both cases; one was grosstotal and the other was subtotal resection. After the operation, symptoms improved mildly in one patient and worsened in the other patient. Both died 3 months after surgery, because of respiratory disturbance due to brain stem compression and lung metastasis. In conclusion, MRI is highly useful for making a diagnosis of intramedullary spinal metastatic tumors. However, it is still difficult to treat such a patient by surgery alone. Further postoperative adjuvant therapy will be necessary to improve the prognosis of such patients.
脊髓髓内转移瘤曾被认为较为罕见,但磁共振成像(MR)及恶性肿瘤治疗方法的出现表明,其实际发生率比我们之前认为的要高。我们报告两例分别源自肺癌和直肠癌的脊髓髓内转移瘤病例。他们的症状迅速加重。我们对两例患者均实施了手术治疗;一例为大体全切,另一例为次全切除。术后,一例患者症状稍有改善,另一例患者症状恶化。两名患者均在术后3个月死亡,死因分别是脑干受压导致的呼吸障碍和肺转移。总之,MRI对诊断脊髓髓内转移瘤非常有用。然而,仅通过手术治疗此类患者仍很困难。需要进一步的术后辅助治疗以改善此类患者的预后。