胸腰椎髓内室管膜下瘤伴多发囊性形成：病例报告并文献复习。
Thoracolumbar intramedullary subependymoma with multiple cystic formation: a case report and review.
机构信息
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, North 15 West 7, Kita-ku, Sapporo, 060-8638, Japan.
出版信息
Eur Spine J. 2013 May;22 Suppl 3(Suppl 3):S317-20. doi: 10.1007/s00586-012-2357-1. Epub 2012 May 5.
BACKGROUND
An intramedullary subependymoma is rare, particularly in the thoracolumbar region. Moreover, a radiographical obvious cystic formation of subependymoma of spinal cord rarely occurs in comparison to ependymoma.
CASE REPORT
A 57-year-old woman presented with paraparesis. MRI revealed a multinodular and multicystic lesion in the spinal cord that was difficult to diagnose correctly. Intraoperative observation via midline myelotomy revealed a grayish, gelatinous solid mass with an eccentric localization. In addition, DREZtomy on the caudal side of the tumor revealed cystic formation. The cyst was punctured and xanthochromic fluid was collected. Attenuation of motor evoked potential (MEP) resulted in the partial removal of tumor. A pathological examination revealed the mass to be a subependymoma. The patient experienced transient worsening of symptoms, but improved gradually. No adjuvant radiosurgery was administered. Follow-up estimation 30 months after surgery revealed no evidences of regrowth.
CONCLUSIONS
This report presents this rare case, a review of the literature associated with thoracolumbar subependymomas, and a discussion of the clinical and radiographical characteristics.
背景
脊髓髓内室管膜下瘤少见，尤其在胸腰椎区域。此外，与室管膜瘤相比，脊髓室管膜下瘤的影像学明显囊性形成更为少见。
病例报告
一名 57 岁女性因截瘫就诊。MRI 显示脊髓内存在多结节和多囊性病变，难以正确诊断。通过正中脊髓切开术术中观察到一个灰白色、胶状的实质性肿块，呈偏心定位。此外，肿瘤尾部的 DREZtomy 显示囊性形成。对囊肿进行穿刺，采集到黄染液体。运动诱发电位（MEP）的衰减导致肿瘤部分切除。病理检查显示肿块为室管膜下瘤。患者出现短暂的症状恶化，但逐渐改善。未进行辅助放射外科治疗。术后 30 个月的随访未发现有肿瘤复发的证据。
结论
本报告介绍了这一罕见病例，对胸腰椎室管膜下瘤相关文献进行了回顾，并对其临床和影像学特征进行了讨论。
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