Tamaki Katsuyoshi, Shimizu Ichiro, Urata Mari, Kohno Nao, Fukuno Hiroshi, Ito Susumu, Sano Nobuya
Department of Digestive and Cardiovascular Medicine, Institute of Health Biosciences, Tokushima University School of Medicine, Kuramoto-cho, Tokushima 770-8503, Japan.
World J Gastroenterol. 2007 May 21;13(19):2758-60. doi: 10.3748/wjg.v13.i19.2758.
Although spinal tumors are uncommon, they may reduce survival or cause serious functional disorders in the extremities. Metastatic spinal tumors from malignant tumors can induce symptoms of spinal cord compression, such as paraplegia, quadriplegia, and vesicorectal disturbance, which are aggravated with progression of the diseases and time. We report a patient with hepatocellular carcinoma (HCC) who was suspected of having spinal lesions based on neurological findings, and a metastatic spinal tumor was found by imaging examination. Assuming that metastasis had occurred at the time lumbar pain developed, the patient reached the level of gait disturbance within only 4 mo, showing a rapid advancement of symptoms. If early diagnosis had been possible, treatment could be performed before acute myelopathy progressed to complete paralysis. We speculate that the terminal stage of HCC is not only liver failure associated with intrahepatic lesions but also metastasis to other regions, treatment for individual pathologies therefore, will be needed, which constitutes an important issue.
尽管脊柱肿瘤并不常见,但它们可能会降低生存率或导致四肢严重的功能障碍。恶性肿瘤的脊柱转移瘤可引发脊髓压迫症状,如截瘫、四肢瘫和膀胱直肠功能障碍,这些症状会随着疾病进展和时间而加重。我们报告了一名肝细胞癌(HCC)患者,根据神经学检查结果怀疑其患有脊柱病变,经影像学检查发现了脊柱转移瘤。假设在出现腰痛时就已发生转移,该患者仅在4个月内就发展到步态障碍程度,症状进展迅速。如果能够早期诊断,就可以在急性脊髓病发展为完全瘫痪之前进行治疗。我们推测,HCC的终末期不仅是与肝内病变相关的肝衰竭,还包括转移到其他部位,因此需要针对个体病理情况进行治疗,这是一个重要问题。