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转移性平滑肌肉瘤至颈椎导致C6椎体压缩性骨折:一例报告。

Leiomyosarcoma metastatic to the cervical spine causing a C6 compression fracture: A case report.

作者信息

Sun Zhenzhong, Wang Heng, Yang Huilin, Jiang Weimin

机构信息

Department of Orthopedics, Wuxi No. 9 People's Hospital, Wuxi, Jiangsu 214062, P.R. China.

Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China.

出版信息

Oncol Lett. 2014 Jul;8(1):263-265. doi: 10.3892/ol.2014.2132. Epub 2014 May 12.

DOI:10.3892/ol.2014.2132
PMID:24959258
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4063593/
Abstract

Leiomyosarcoma is a rare malignant tumor derived from smooth muscle cells, which commonly metastasizes to the lungs, liver, kidney, brain and skin. The current study presents the case of a 42-year-old male who presented with progressive neck pain and numbness of the left arm. Spinal computed tomography and magnetic resonance imaging revealed osteolytic lesions of numerous vertebrae (C2, C3, C4, C5, C6, C7, T1 and T2). With regard to the C6 vertebra, total destruction of the vertebral body resulted in vertebral collapse and subsequent spinal cord compression. The patient underwent an anterior C6 corpectomy, reconstruction with a mesh cage filled with polymethyl methacrylate (PMMA) and open PMMA infusion to C5 and C7. The surgical procedure significantly alleviated the symptoms and obtained a reliable reconstruction. The clinical follow-up examination at 13 months was uneventful with the exception of mild numbness of the left hand since the surgery. To the best of our knowledge, this is the first case of leiomyosarcoma recurrence presenting in the cervical spine, and the present study provides insight into the use of a surgical technique that has rarely been used in the cervical spine.

摘要

平滑肌肉瘤是一种源自平滑肌细胞的罕见恶性肿瘤,通常会转移至肺、肝、肾、脑和皮肤。本研究报告了一名42岁男性病例,该患者出现进行性颈部疼痛和左臂麻木。脊柱计算机断层扫描和磁共振成像显示多个椎体(C2、C3、C4、C5、C6、C7、T1和T2)存在溶骨性病变。就C6椎体而言,椎体完全破坏导致椎体塌陷并随后压迫脊髓。患者接受了C6椎体前路切除术,使用填充有聚甲基丙烯酸甲酯(PMMA)的网笼进行重建,并向C5和C7开放注入PMMA。手术显著缓解了症状并实现了可靠的重建。术后13个月的临床随访检查除了自手术以来左手轻度麻木外,无其他异常情况。据我们所知,这是首例颈椎出现平滑肌肉瘤复发的病例,本研究为一种很少在颈椎使用的手术技术的应用提供了见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/0db78dbfae52/OL-08-01-0263-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/679b556d3e8a/OL-08-01-0263-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/c07d5370e488/OL-08-01-0263-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/f5254690ac51/OL-08-01-0263-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/0db78dbfae52/OL-08-01-0263-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/679b556d3e8a/OL-08-01-0263-g00.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/c07d5370e488/OL-08-01-0263-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/f5254690ac51/OL-08-01-0263-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e875/4063593/0db78dbfae52/OL-08-01-0263-g03.jpg

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本文引用的文献

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Partial spondylectomy for primary leiomyosarcoma of C2 vertebra.颈椎 2 椎体原发性平滑肌肉瘤的部分脊柱切除术。
Spine (Phila Pa 1976). 2011 Oct 1;36(21):E1422-6. doi: 10.1097/BRS.0b013e31820a79c6.
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