Chen Kai-Yuan, Wu Jau-Ching, Lin Shih-Cheih, Huang Wen-Cheng, Cheng Henrich
Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2014 Nov;77(11):594-7. doi: 10.1016/j.jcma.2014.06.007. Epub 2014 Aug 12.
We report a case of the coexistence of different spinal tumors at the same level of the cervical spine, without neurofibromatosis (NF), which was successfully treated with surgery. A 72-year-old female presented with right upper-limb clumsiness and weakness. Magnetic resonance imaging revealed an intradural, extramedullary tumor mass at the right C3-4 level with extradural extension into the intervertebral foramen. The extradural tumor was removed, and the pathology showed neurofibroma. After incision of the dura, the intradural tumor was removed, and was identified as meningioma in the pathological report. The patient did not meet the criteria of NF. Coexistence of neurofibroma and meningioma at exactly the same level of the spine without NF is extremely rare. Exploration of the intradural space may be necessary after resection of an extradural tumor if the surgical finding does not correlate well with the preoperative images.
我们报告一例在颈椎同一水平存在不同脊柱肿瘤且无神经纤维瘤病(NF)的病例,该病例通过手术成功治疗。一名72岁女性出现右上肢笨拙和无力症状。磁共振成像显示在右侧C3 - 4水平有一个硬膜内、髓外肿瘤肿块,并硬膜外延伸至椎间孔。切除硬膜外肿瘤,病理显示为神经纤维瘤。切开硬脑膜后,切除硬膜内肿瘤,病理报告显示为脑膜瘤。该患者不符合NF的标准。在无NF的情况下,神经纤维瘤和脑膜瘤在脊柱完全相同水平共存极为罕见。如果手术所见与术前影像不太相符,在切除硬膜外肿瘤后可能有必要探查硬膜内间隙。