Hirata Ayako, Nomoto Nobuatsu, Konno Shingo, Nakazora Hiroshi, Sugimoto Hideki, Nemoto Hiroshi, Kurihara Teruyuki, Wakata Nobuo
Department of Neurology, Toho University School of Medicine, Oohashi Hospital, Tokyo.
Intern Med. 2006;45(14):875-7. doi: 10.2169/internalmedicine.45.1811. Epub 2006 Aug 15.
We report a rare case of subacute combined degeneration of the spinal cord concomitant with gastric cancer. A 67-year-old man was admitted because of posterior column symptoms, pyramidal tract sign and peripheral neuropathy with severe hyperchromic anemia. He was treated with mecobalamin 1 mg IM, after which his anemia and neurological signs recovered. He was diagnosed as having subacute combined degeneration with pernicious anemia. Subsequent stomach biopsy revealed gastric cancer, and the patient underwent gastrectomy. It is a well known association that chronic atrophic gastritis is associated with gastric cancer or subacute combined degeneration. Our findings suggest that in this case subacute combined degeneration and gastric cancer are independent of each other; rather, both resulted from chronic atrophic gastritis.
我们报告一例罕见的脊髓亚急性联合变性合并胃癌病例。一名67岁男性因后柱症状、锥体束征和伴有严重高色素性贫血的周围神经病变入院。他接受了1毫克甲钴胺肌肉注射治疗,之后贫血和神经体征恢复。他被诊断为伴有恶性贫血的脊髓亚急性联合变性。随后的胃部活检显示为胃癌,患者接受了胃切除术。慢性萎缩性胃炎与胃癌或脊髓亚急性联合变性相关,这是众所周知的关联。我们的研究结果表明,在该病例中,脊髓亚急性联合变性和胃癌相互独立;相反,两者均由慢性萎缩性胃炎引起。