Department of Orthopaedic, Beaujon hospital, Clichy, France.
Spine (Phila Pa 1976). 2009 Nov 1;34(23):E857-60. doi: 10.1097/BRS.0b013e3181b780e9.
A case report.
To illustrate a rare case of oncogenous osteomalacia caused by a spinal thoracic myopericytoma.
Osteomalacia related to a tumor is well known. The cause of the disorder is usually a highly vascularized, benign tumor of mesenchymal origin. Location of the tumor in the spine is very rare. Removal of the tumor is followed by resolution of osteomalacia.
Diagnosis of oseomalacia was established on the presence of cardinal clinical, biologic, and radiologic features of osteomalacia. Localization of the tumor at T5 and T6 levels was obtained by magnetic resonance imaging. Surgical treatment consisted in a circumferential correction-fusion with hemivertebrectomy of T5 and T6 and tumor removal.
Tumor removal was rapidly followed by disappearance of the clinical symptoms of osteomalacia, and by correction of hypophosphatemia. At 2-years follow-up, no recurrence of the tumor was detectable on imaging studies-the correction fusion remained stable. Histologically, the tumor was classified as a myopericytoma. There was no relapse of the clinical features of osteomalacia. However, secondary recurrence of the biologic markers due to an incomplete tumor removal was disclosed.
Removal of the tumor was followed by healing of the clinical features of osteomalacia, demonstrating the causal connection between the myopericytoma and the osteopathy.
病例报告。
阐述一例由胸段脊柱肌纤维母细胞瘤引起的罕见癌源性骨软化症病例。
与肿瘤相关的骨软化症众所周知。该疾病的病因通常是源自间充质的高度血管化良性肿瘤。肿瘤位于脊柱的情况非常罕见。肿瘤切除后骨软化症会得到缓解。
骨软化症的诊断依据是骨软化症的典型临床、生物学和影像学特征。通过磁共振成像确定肿瘤位于 T5 和 T6 水平。手术治疗包括 T5 和 T6 的全脊椎切除和肿瘤切除的环周矫正融合。
肿瘤切除后，骨软化症的临床症状迅速消失，血磷酸盐水平也得到纠正。2 年随访时，影像学检查未发现肿瘤复发——矫正融合保持稳定。组织学上，肿瘤被归类为肌纤维母细胞瘤。骨软化症的临床特征无复发。然而，由于肿瘤切除不完全，生物标志物的二次复发被揭示。
肿瘤切除后骨软化症的临床症状得到缓解，表明肌纤维母细胞瘤与骨病之间存在因果关系。
