Takahashi I, Isu T, Iwasaki Y, Akino M, Takahashi A, Abe H, Kitagawa M, Kojima H, Inoue K, Saitoh H
Department of Neurosurgery, Hokkaido University, School of Medicine.
No Shinkei Geka. 1990 Dec;18(12):1157-60.
A case of Grawitz's tumor metastasizing to the cauda equina is presented. A 51-year-old male was hospitalized due to severe low back pain radiating to the left lower extremity. Neurological examination showed only hyporeflexia of the left patella reflex and positive Lasegue's sign. MRI showed intradural mass at the L4 level. Preoperatively, we diagnosed a cauda equina tumor. A laminectomy of both L3 and L4 was performed, and total removal of the cauda equina tumor was performed. Microscopically, the tumor cells were large, the appearance of the cytoplasm ranging from optically clear with sharply outlined boundaries, to deeply granular, with many transitional forms. These histological findings were typical findings of Grawitz's tumor, and were the same as those of this patient's renal tumor. Finally, we diagnosed Grawitz's tumor metastasizing to the cauda equina. Metastatic cauda equina tumor from outside the central nervous system is very rare and only 7 cases have been reported. This case is the first one of Grawitz's tumor spreading to the cauda equina.
本文报告1例转移至马尾的格腊维茨氏瘤。一名51岁男性因严重的下背部疼痛放射至左下肢而住院。神经学检查仅显示左髌骨反射减退及直腿抬高试验阳性。磁共振成像显示L4水平硬膜内肿块。术前，我们诊断为马尾肿瘤。行L3和L4双侧椎板切除术，并完整切除马尾肿瘤。显微镜下，肿瘤细胞较大，细胞质外观从光学上透明且边界清晰到深颗粒状，有许多过渡形式。这些组织学表现是格腊维茨氏瘤的典型表现，与该患者肾肿瘤的表现相同。最后，我们诊断为转移至马尾的格腊维茨氏瘤。中枢神经系统外转移至马尾的肿瘤非常罕见，仅报道过7例。该病例是首例格腊维茨氏瘤扩散至马尾的病例。
