Komatsu Shuji, Iseki Masako, Morita Yoshihito, Inada Eiichi
Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, Tokyo 113-8431.
Masui. 2013 Jul;62(7):863-6.
While attempting to treat a 71-year-old male patient who had been diagnosed with sciatica from spinal canal stenosis, we discovered his prior cancer metastasizing to the psoas. We initially administered epidural block to him after confirming his prior rectal cancer had not metastasized to lumbar vertebral bones, but the block did not satisfactorily alleviate his pain, and he had difficulty stretching his lower limbs. CT scan to re-examine the cause revealed a metastasized cancer in the psoas. From this experience, we believe malignant psoas syndrome should be considered in addition to metastasis to lumbar vertebral bones, when evaluating lower back to lower limb pain in patients with previous cancer history.
在试图治疗一名71岁被诊断为椎管狭窄导致坐骨神经痛的男性患者时,我们发现他之前的癌症已转移至腰大肌。在确认他之前的直肠癌未转移至腰椎骨后,我们最初给他进行了硬膜外阻滞,但该阻滞未能令人满意地缓解他的疼痛,且他下肢伸展困难。重新检查病因的CT扫描显示腰大肌有转移癌。从这次经历中,我们认为在评估有癌症病史患者的腰背部至下肢疼痛时,除了考虑癌症转移至腰椎骨外,还应考虑恶性腰大肌综合征。