经后路腹侧切除术治疗的转移性滑膜肉瘤伴颈髓压迫：病例报告
Metastatic synovial sarcoma with cervical spinal cord compression treated with posterior ventral resection: case report.
作者信息
Arnold Paul M, Roh Simon, Ha Tung M, Anderson Karen K
机构信息
University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 3021, Kansas City, KS 66160, USA.
出版信息
J Spinal Cord Med. 2010;33(1):80-4. doi: 10.1080/10790268.2010.11689679.
CONTEXT
Synovial sarcomas, which represent 5% to 10% of all adult soft-tissue sarcomas, usually metastasize to the lungs. Metastasis to the spine is rare. Spinal cord compression due to spinal metastasis occurs in approximately 3% of patients with extraspinal soft-tissue sarcomas.
METHOD
Case report.
FINDINGS
A 26-year-old woman presented with neck pain, arm weakness, and a history of metastatic synovial sarcoma originating at the right knee. Computed tomography revealed destruction of the odontoid and C2 body. Magnetic resonance imaging revealed tumor in the posterior elements of C2 and in the ventral epidural space from C2-C5. She was treated with C2-C3 laminectomy, posterior C2 corpectomy with occipital-C7 fixation, and fusion. Postoperatively, her neck pain resolved and left upper extremity strength returned to normal.
CONCLUSION AND CLINICAL RELEVANCE
Metastatic spinal cord compression from synovial sarcoma is rare. Surgical resection can lead to neurologic improvement.
背景
滑膜肉瘤占所有成人软组织肉瘤的5%至10%，通常会转移至肺部。转移至脊柱的情况罕见。脊柱转移导致的脊髓压迫约发生在3%的脊柱外软组织肉瘤患者中。
方法
病例报告。
结果
一名26岁女性，出现颈部疼痛、手臂无力，既往有起源于右膝的转移性滑膜肉瘤病史。计算机断层扫描显示齿状突和C2椎体破坏。磁共振成像显示C2后部及C2至C5腹侧硬膜外间隙有肿瘤。她接受了C2至C3椎板切除术、C2后路椎体切除术并枕颈至C7固定及融合术。术后，她的颈部疼痛缓解，左上肢力量恢复正常。
结论及临床意义
滑膜肉瘤导致的转移性脊髓压迫罕见。手术切除可使神经功能得到改善。
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