Akgun Bekir, Ates Deniz, Kaplan Metin
Firat University Hospital, Department of Neurosurgery, Elazig, Turkey.
Acta Medica (Hradec Kralove). 2012;55(1):50-2. doi: 10.14712/18059694.2015.76.
An eight-month-old male child was admitted with weakness and swelling in the feet. Paraparesis and bilateral lower extremity edema were present in the neurological examination. Thoracic MRI showed an intradural intramedullary mass 61 x 11 mm in size in the T5-T10 levels. Laminotomy between the T5-T10 vertebrae was performed. A mass with smooth borders was separated from most of the neural tissue. In the postoperative MRI, we observed a contrast enhancing area, considered a residual fragment, only 5 x 4 mm in size. Histopathological properties were compatible with the intermixed subtype of ganglioneuroblastoma. Only a limited number of thoracic cord Ganglioneuroblastoma reports have been previously published. Although very rare in children and young adults, ganglioneuroblastoma should be included in the differential diagnosis of thoracic cord tumors. It is difficult to obtain a preoperative diagnosis with clinical features and radiological investigations. Diagnosis depends on histopathological examinations. Curative treatment should be in the form of a complete resection of the tumor. In partially resected cases, adjuvant radiotherapy may become necessary, along with close follow-up.
一名八个月大的男童因足部无力和肿胀入院。神经系统检查发现双下肢轻瘫和双侧下肢水肿。胸椎磁共振成像(MRI)显示在T5 - T10水平有一个大小为61×11毫米的硬膜内髓内肿块。在T5 - T10椎体之间进行了椎板切开术。一个边界光滑的肿块与大部分神经组织分离。术后MRI显示有一个强化区域,考虑为残留碎片,大小仅为5×4毫米。组织病理学特征与神经母细胞瘤混合亚型相符。此前仅有有限数量的胸椎神经母细胞瘤报告发表。神经母细胞瘤在儿童和年轻人中非常罕见,但在胸椎肿瘤的鉴别诊断中应予以考虑。通过临床特征和放射学检查很难获得术前诊断。诊断依赖于组织病理学检查。根治性治疗应以肿瘤完全切除的形式进行。在部分切除的病例中,除密切随访外,辅助放疗可能成为必要手段。