Uglialoro Anthony D, Beebe Kathleen S, Hameed Meera, Benevenia Joseph
Department of Orthopedics, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, New Jersey 07103, USA.
Orthopedics. 2009 Jun;32(6):445. doi: 10.3928/01477447-20090511-22.
This article presents a case of a 53-year-old woman who presented with intermittent, dull, poorly localized lower back and buttock pain. The pain worsened in a seated position or after long periods of standing. A T1-weighted magnetic resonance image (MRI) of the sacrum and coccyx revealed a well-demarcated intraosseous lesion with homogeneous low signal intensity, while T2-weighted MRIs demonstrated homogeneous high signal intensity. An excisional biopsy revealed benign notochord cell tumor. The biopsy proved to be effective, as it relieved the patient's coccydynia. Due to the rarity of intraosseous benign notochordal cell tumors, it is essential to document and review this type of tumor. Only 2 benign notochordal cell tumors involving the coccyx have been previously reported, both of which presented with the same clinical symptoms of chronic coccydynia as our patient, likely due to the location of the involved lesion. The other leading diagnosis in our patient was chordoma, a malignant and locally aggressive neoplasm that is important to consider and exclude. Although chordomas have been well characterized in the surgery, pathology, and radiology literature, the benign notochordal cell tumor is a relative newcomer.
本文介绍了一例53岁女性患者，其表现为间歇性、钝痛、部位不明确的下背部和臀部疼痛。疼痛在坐位或长时间站立后加重。骶骨和尾骨的T1加权磁共振成像（MRI）显示一个边界清晰的骨内病变，信号强度均匀较低，而T2加权MRI显示信号强度均匀较高。切除活检显示为良性脊索细胞瘤。活检证明是有效的，因为它缓解了患者的尾骨痛。由于骨内良性脊索细胞瘤罕见，记录和回顾这类肿瘤至关重要。此前仅报道过2例累及尾骨的良性脊索细胞瘤，两者均表现出与我们的患者相同的慢性尾骨痛临床症状，这可能是由于受累病变的位置所致。我们患者的另一个主要诊断是脊索瘤，这是一种恶性且具有局部侵袭性的肿瘤，需要考虑并排除。尽管脊索瘤在外科、病理学和放射学文献中已有充分描述，但良性脊索细胞瘤相对较新。
