Kaczmarek Krystian, Wiącek Marta P, Sulewski Adam, Kubaszewski Łukasz, Kaczmarczyk Jacek, Nowakowski Andrzej
Department of General, Oncologic and Endocrine Surgery, Voivodeship Hospital in Kielce, Kielce, Poland.
Department of Spinal Surgery, Orthopedic Oncology and Traumatology, W. Dega University Hospital Poznań, Poznań, Poland.
Pol Orthop Traumatol. 2014 Jan 3;79:1-4.
Male breast cancer (MBC) represents a rare cause of vertebral body compression fractures along with severe pain restricting the patient's daily functioning. Limited number of cases, lack of awareness among patients and physicians leading to delayed management, further increase the average age and disease progression at presentation, resulting in a poor prognosis. Additionally, studies on MBC treatment protocols and the use of female algorithms are unavailable. The implementation of vertebroplasty or kyphoplasty often results in unsatisfactory outcome due to recurrent pain and loss of vertebral height. Stentoplasty could become an alternative procedure, as described in the following case study.
54-yr-old male patient with history of breast carcinoma presented with pain in the vertebral column. Baseline X-ray and CT scan revealed multiple osteosclerotic and osteolytic metastatic lesions in the thoracic vertebrae along with a compression fracture at T9. Stentoplasty was performed to limit fracture progression. Intraoperative scan revealed restoration of the vertebral body shape. Following surgery, direct reduction in pain was obtained. Postoperative 1-year follow-up did not show any loss in height of the operated vertebra. Results of adjuvant chemotherapy administration and a new method of treatment of compression fractures caused by metastatic lesions were compared with previously published studies.
Stentoplasty with Vertebral Body Stenting-System is an innovative method that can be applied in kyphoplasty for compression fractures caused by metastatic lesions. Nevertheless, further research on the systemic treatment of MBC is needed.
男性乳腺癌（MBC）是椎体压缩性骨折的罕见病因，同时伴有严重疼痛，限制了患者的日常活动。病例数量有限，患者和医生认识不足导致治疗延迟，进一步增加了就诊时的平均年龄和疾病进展，预后较差。此外，关于MBC治疗方案和女性算法应用的研究尚不可用。椎体成形术或后凸成形术的实施往往因疼痛复发和椎体高度丢失而导致效果不理想。如以下病例研究所述，支架成形术可能成为一种替代手术。
一名54岁有乳腺癌病史的男性患者出现脊柱疼痛。基线X线和CT扫描显示胸椎有多个骨硬化和溶骨性转移病灶，同时T9椎体有压缩性骨折。进行支架成形术以限制骨折进展。术中扫描显示椎体形状恢复。术后疼痛直接减轻。术后1年随访未显示手术椎体高度有任何丢失。将辅助化疗给药结果和转移性病变所致压缩性骨折的新治疗方法与先前发表的研究进行了比较。
使用椎体支架系统进行支架成形术是一种创新方法，可应用于后凸成形术治疗转移性病变所致压缩性骨折。然而，仍需要对MBC的系统治疗进行进一步研究。
