Martín Escudero J C, Aparicio Blanco M, Borrego Pintado H, del Villar Negro A, Carretero Sastre J L, Velasco Fernández C
Servicio de Medicina Interna, Hospital del Río Hortega, Valladolid.
An Med Interna. 1991 Oct;8(10):497-500.
Two cases of necrotic myelopathy are presented. This is a very rare paraneoplasic syndrome. One patient had clear cell renal carcinoma and other had lymphatic metastasis of malignant melanoma without filiation of the primary tumor. The complete spinal study (MNR, CT, myelography) proved normal. Diagnosis is possible when all other causes of spinal disease have been discarded. Nowadays, it is possible to diagnose this disease premortem. The international literature reviewed showed 31 cases published since 1903, associated mainly to malignant diseases such as lymphomas, lung cancer, renal carcinoma, breast cancer, leukemias, etc. The differential diagnosis appears in the comments, as well as the presentation and evolution of the cases described up until now.
本文报告了两例坏死性脊髓病。这是一种非常罕见的副肿瘤综合征。一名患者患有透明细胞肾细胞癌,另一名患者有恶性黑色素瘤的淋巴转移,原发肿瘤未明确。完整的脊柱检查(磁共振成像、计算机断层扫描、脊髓造影)结果正常。当排除了脊髓疾病的所有其他病因后,即可作出诊断。如今,有可能在生前诊断出这种疾病。回顾的国际文献显示,自1903年以来共发表了31例病例,主要与淋巴瘤、肺癌、肾癌、乳腺癌、白血病等恶性疾病相关。鉴别诊断在评论中呈现,同时还介绍了迄今为止所描述病例的表现及病程。