Departments of 1 Neurosurgery and.
J Neurosurg Spine. 2014 Oct;21(4):618-22. doi: 10.3171/2014.5.SPINE13992. Epub 2014 Jul 8.
Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation. The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10-11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs. This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years.
在过去的十年中,人类细胞移植和神经干细胞试验已经研究了这些潜在疗法治疗各种神经疾病的可行性和安全性。然而,由于异位、不受控制的细胞生长和肿瘤形成的可能性,这些试验引起了重大的安全问题。作者报告了一例 18 岁女性的病例,她在 T10-11 处发生完全性脊髓损伤。受伤后 3 年,她仍然截瘫,并在损伤部位进行了嗅粘膜细胞移植。8 年后,她出现背痛,影像学检查显示在细胞移植部位的脊髓内有一个髓内脊髓肿块,需要切除。术中发现脊髓扩张,有一个多囊肿肿块,其中含有大量浓稠的粘液样物质。组织学检查和免疫组织化学染色显示,该肿块主要由呼吸上皮衬里的囊肿、含有杯状细胞的黏膜下腺体和中间的神经分支组成。这是首例人类脊髓肿块合并脊髓细胞移植和神经干细胞治疗的报告。鉴于发病时间较长,所有接受细胞移植和神经干细胞植入的患者都应在多年内进行安全监测。
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