Viard H, Sautreaux J L, Cougard P, Bernard A, Paris P, Goudet P
Clinique Chirurgicale, Hôpital du Bocage, Dijon.
Ann Chir. 1991;45(8):699-703.
The authors present 5 cases of dumbbell neurogenic tumors with intraspinal extension. There were 4 neurilemmomas in four adults and 1 ganglioneuroma in one child. These tumors were benign. Neurological signs were observed in two cases. Widening of the intervertebral foramen at the level of the tumor is a very suggestive sign of dumbbell tumor confirmed by CT-Scan or MRI. Precise morphologic features must be assessed before embarking on the operation. The procedures used were: thoracotomy only in two cases, laminectomy then thoracotomy because of neurological signs in two cases, thoracotomy then laminectomy to fully remove tumor remnants in one case. No major morbidity was noted. The neurological symptoms resolved in two cases. A combined two-team approach with thoracic and neurosurgeons working together has not been used so far, but this possibility is probably the best choice for the future.
作者报告了5例哑铃型神经源性肿瘤伴脊髓内延伸的病例。其中4例为神经鞘瘤，患者为4名成年人，1例为神经节神经瘤，患者为1名儿童。这些肿瘤均为良性。2例出现神经系统体征。肿瘤水平的椎间孔增宽是哑铃型肿瘤的一个非常有提示性的征象，CT扫描或MRI可证实。在开始手术前必须评估精确的形态学特征。采用的手术方式有：2例仅行开胸手术；2例因出现神经系统体征，先行椎板切除术再行开胸手术；1例先行开胸手术再行椎板切除术以完全清除肿瘤残余。未发现重大并发症。2例患者的神经症状得到缓解。目前尚未采用胸外科医生和神经外科医生联合的双团队手术方式，但这种可能性可能是未来的最佳选择。
