Fukushima Tatsuki, Kasai Yuichi, Kato Ko, Fujisawa Kozo, Uchida Atsumasa
Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu City, Mie, Japan.
World J Surg Oncol. 2009 Feb 11;7:16. doi: 10.1186/1477-7819-7-16.
Leptomeningeal carcinomatosis occurs in patients with cancer at the rate of approximately 5%; it develops particularly in patients with breast cancer, lung cancer, melanoma, leukemia, or malignant lymphoma. We describe a rare case of leptomeningeal carcinomatosis in which spinal intradural squamous cell carcinoma with no lesions in the cerebral meninges and leptomeninx, was the primary lesion.
A 64-year-old man complained of sacral pain. Although the patient was treated with analgesics, epidural block and nerve root block, sacral pain persisted. Since acute urinary retention occurred, he was operated on. The patient was diagnosed as having an intradural squamous cell carcinoma of unknown origin.
Since the patient presented with a slightly decreased level of consciousness 2 months after surgery, he was subjected to MRI scanning of the brain and spinal cord, which revealed disseminated lesions in the medulla oblongata. The patient died of pneumonia and sepsis caused by methicillin-resistant Staphylococcus aureus 5 months after surgery.
We report the first case of a patient with intradural squamous cell carcinoma with unknown origin that developed independently in the sacrum.
癌性脑膜炎在癌症患者中的发生率约为5%；尤其在乳腺癌、肺癌、黑色素瘤、白血病或恶性淋巴瘤患者中易发生。我们描述了一例罕见的癌性脑膜炎病例，其原发性病变为脊髓硬膜内鳞状细胞癌，而脑膜和软脑膜无病变。
一名64岁男性主诉骶骨疼痛。尽管患者接受了镇痛药、硬膜外阻滞和神经根阻滞治疗，但骶骨疼痛仍持续存在。由于出现急性尿潴留，对其进行了手术。患者被诊断为来源不明的硬膜内鳞状细胞癌。
术后2个月患者出现意识水平略有下降，遂对其进行脑和脊髓的MRI扫描，结果显示延髓有播散性病变。患者术后5个月死于耐甲氧西林金黄色葡萄球菌引起的肺炎和败血症。
我们报告了首例起源不明的硬膜内鳞状细胞癌独立发生于骶骨的病例。
