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缓解期颅内生殖细胞瘤沉积致马尾综合征的有效放疗

Effective radiotherapy cured cauda equina syndrome caused by remitted intracranial germinoma depositing.

机构信息

Department of Pediatrics, Tri-Service General Hospital, Taipei, Taiwan.

出版信息

Pediatr Neonatol. 2012 Oct;53(5):315-9. doi: 10.1016/j.pedneo.2012.07.007. Epub 2012 Sep 12.

Abstract

Cauda equina syndrome (CES) in children is very rare and can permanently disable. A remitted intracranial germinoma depositing on the spinal cord, leading to CES, has never been reported. We discuss the case of a 10-year-old girl who presented with sudden ataxia, low back pain, sensory deficits of the left lower extremity, and difficulty urinating and defecating 7 months after totally remitted intracranial germinoma postintracranial surgery and cranial irradiation. Magnetic resonance imaging (MRI) of the brain and spine showed multiple intradural extramedullary homogeneous masses from the cervical to lumbar levels, compressing the conus medullaris and cauda equina. After emergent craniospinal irradiation, the patient's neurologic symptoms dramatically subsided. A remitted intracranial germinoma depositing on her spinal cord could be the cause of CES. Early identification and a proper craniospinal irradiation may halt the progression of symptoms.

摘要

儿童马尾综合征(CES)非常罕见,但可导致永久性残疾。在脊髓上沉积的颅内生殖细胞瘤缓解后导致 CES 的情况尚未见报道。我们讨论了 10 岁女孩的病例,她在颅内生殖细胞瘤颅内手术后和颅部放疗后完全缓解 7 个月后出现突然共济失调、腰痛、左下肢感觉缺失以及排尿和排便困难。颅脑和脊柱的磁共振成像(MRI)显示从颈段到腰段多个硬脊膜外髓内均匀肿块,压迫圆锥和马尾。紧急进行颅脊髓放疗后,患者的神经症状显著缓解。可能是颅内生殖细胞瘤缓解后在脊髓上沉积导致 CES。早期识别和适当的颅脊髓放疗可能会阻止症状的进展。

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