Oka H, Tachibana S, Yada K, Suwa T, Iida H, Mii K
Department of Neurosurgery, Kitasato University School of Medicine.
No Shinkei Geka. 1992 May;20(5):599-603.
A 62-year-old woman was admitted complaining of clumsiness in both hands. On neurological examination, bilateral hand muscles were weak, both legs were spastic and hyperreflexic, all the extremities were hypoesthetic. Urological examination revealed detruser sphincter dyssynergia. Spinal CT scan demonstrated an iso density mass lesion in the cervical spinal cord, and it was markedly enhanced. On MRI, it was also markedly enhanced by Gd-DTPA. The operative finding was that an oval shaped tumor was buried in the spinal cord and was totally removed. Its histological diagnosis was neurofibroma. Intramedullary neurofibroma is rare and only 18 cases have been reported. In this case the tumor seemed to have arisen at the root entry zone and to have grown sub-pially.
一名62岁女性因双手笨拙而入院。神经系统检查发现，双侧手部肌肉无力，双腿痉挛且反射亢进，四肢感觉减退。泌尿外科检查显示逼尿肌括约肌协同失调。脊髓CT扫描显示颈髓有等密度肿块病变，且明显强化。在磁共振成像（MRI）上，钆喷酸葡胺（Gd-DTPA）增强扫描也显示其明显强化。手术所见为一个椭圆形肿瘤埋于脊髓内，已被完全切除。其组织学诊断为神经纤维瘤。髓内神经纤维瘤罕见，仅报道过18例。在本病例中，肿瘤似乎起源于神经根进入区并在软膜下生长。
