Oyanagi Kiyomitsu, Ogata Kentaro, Takeda Shigeki, Horikawa Yo, Kawakami Emiko, Morita Takashi
Department of Neuropathology, Tokyo Metropolitan Institute for Neuroscience, Fuchu, Tokyo, Japan.
Neuropathology. 2003 Dec;23(4):296-300. doi: 10.1046/j.1440-1789.2003.00508.x.
The present case is the first autopsy case of prostatic carcinoma presenting widespread spinal epidural venous plexus tumor cell emboli with wedge-shaped spinal cord lesions. There has been no previous report of prostatic carcinoma showing tumor cell emboli in the spinal and cranial base epidural venous plexus, in spite of the fact that the incidence of vertebral metastasis in prostatic carcinoma is high, and that presence of continuity from pelvic organs to venous plexus around vertebrae, up to foramen magnum, has been reported. The present case shows that the possibility of spinal cord injury, not by direct compression, but by venous circulatory disturbance as a result of tumor cell emboli to veins, should be taken into consideration on medical treatment of prostatic carcinoma.
本病例是首例前列腺癌尸检病例，呈现广泛的脊髓硬膜外静脉丛肿瘤细胞栓子及楔形脊髓病变。尽管前列腺癌椎体转移发生率较高，且有报道称盆腔器官与椎骨周围静脉丛直至枕骨大孔存在连续性，但此前尚无前列腺癌在脊髓和颅底硬膜外静脉丛出现肿瘤细胞栓子的报告。本病例表明，在前列腺癌的医学治疗中，应考虑到脊髓损伤的可能性，其并非由直接压迫所致，而是肿瘤细胞栓子进入静脉导致静脉循环障碍所致。
