Bambakidis Nicholas C, Gore Pankaj, Eschbacher Jennifer, Coons Stephen, Albuquerque Felipe C
Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Neurosurgery. 2007 Jun;60(6):E1152-3; discussion E1153. doi: 10.1227/01.NEU.0000255463.37634.F2.
Glomus tumors are rare lesions that can arise intraosseously along the entire spinal axis. Only four cases have been reported, usually manifesting with severe back pain and involving the midthoracic spine or sacrum. The current report describes the largest such lesion reported in the literature to date and summarizes the clinical and pathological characteristics of these rare tumors.
A single, recent case arising from the lumbar vertebra of L3 is described, and the literature of intraosseous spinal glomus tumors is reviewed.
The lesion described arose in a 44-year-old man with a 1-year history of neurological symptoms and a large dumbbell-shaped lesion involving the lumbar vertebra, which extended through the neural foramen at L3. The lesion was resected using a two-stage approach. Severe intraoperative hemorrhage necessitated emergent angiographic embolization. Histopathological examination confirmed the presence of a glomus tumor arising from the smooth muscle cells of the glomus body.
These rare lesions may extend into the epidural space and through the neural foramina and abdominal compartments; over time, they grow very large. Preoperative embolization may be indicated for large tumors suspected to be glomus tumors.
血管球瘤是一种罕见的病变，可沿整个脊柱轴在骨内发生。文献中仅报道过4例，通常表现为严重背痛，累及胸段脊柱中部或骶骨。本报告描述了迄今为止文献报道中最大的此类病变，并总结了这些罕见肿瘤的临床和病理特征。
描述了1例近期发生于L3腰椎的病例，并复习了骨内脊柱血管球瘤的文献。
所述病变发生在一名44岁男性身上，该男性有1年的神经症状病史，存在一个累及腰椎的巨大哑铃形病变，该病变延伸至L3神经孔。采用两阶段方法切除病变。术中严重出血需要紧急血管造影栓塞。组织病理学检查证实存在起源于血管球体平滑肌细胞的血管球瘤。
这些罕见病变可能延伸至硬膜外间隙、通过神经孔和腹腔；随着时间推移，它们会长得非常大。对于怀疑为血管球瘤的大肿瘤，术前栓塞可能是必要的。
