一名晚期食管癌患者的副肿瘤性坏死性脊髓病：一例尸检病例报告。

Paraneoplastic necrotizing myelopathy in a patient with advanced esophageal cancer: An autopsied case report.

作者信息

Urai Yoshiteru, Matsumoto Kouichi, Shimamura Mieko, Ikeda Kazuyo, Tsukaguchi Masago, Deguchi Kazushi, Touge Tetsuo, Ueno Masaki, Sakamoto Haruhiko, Kuriyama Shigeki, Kinekawa Fumihiko, Kurokohchi Kazutaka, Uchida Naohito, Masaki Tsutomu

机构信息

Department of Gastroenterology and Neurology, School of Medicine, Kagawa University, Japan.

出版信息

J Neurol Sci. 2009 May 15;280(1-2):113-7. doi: 10.1016/j.jns.2009.02.324. Epub 2009 Mar 9.

DOI:10.1016/j.jns.2009.02.324

PMID:19272613

Abstract

We report the first autopsied case of paraneoplastic necrotizing myelopathy associated with esophageal cancer in the literature. The patient had acute flaccid paraplegia and urinary retention, and had a good recovery of strength of both legs in response to corticosteroids. MRI showed a characteristic lesion with post-gadolinium enhancement of the cervical to mid-thoracic spinal cord at the onset, which has never been reported. Taken together, these results suggest that there is an underlying autoimmune mechanism in paraneoplastic necrotizing myelopathy.

摘要

我们报告了文献中首例与食管癌相关的副肿瘤性坏死性脊髓病尸检病例。该患者出现急性弛缓性截瘫和尿潴留，使用皮质类固醇后双下肢力量恢复良好。MRI显示起病时颈段至胸段脊髓有特征性病变，注射钆对比剂后有强化，此前未见报道。综合来看，这些结果提示副肿瘤性坏死性脊髓病存在潜在的自身免疫机制。