Merchant Shuaib, Mohiyuddin S M Azeem, Rudrappa Satish, Deo R P, A Sagayaraj, Menon Lakshmi R
Department of ENT and Head and Neck Surgery, Sri Devraj Urs Medical College, Tamaka Kolar, 563101 India.
Department of Spine Surgery, Manipal Hospital, Bangalore, 560017 India.
Indian J Surg Oncol. 2014 Dec;5(4):293-6. doi: 10.1007/s13193-014-0350-3. Epub 2014 Sep 14.
To highlight an uncommon bone malignancy, which presented to our institute, as a neck swelling in the supraclavicular region. A 30 year old man presented with history of swelling on the left side of neck since 1 year and numbness of left upper limb since 6 months. Magnetic Resonance Imaging of the Cervical spine & MR Angiography showed a 7.4 × 4.6 cm expansile lesion involving transverse process of C5-C7 vertebrae. As the tumour was found to be deep to the phrenic nerve & brachial plexus, a dual approach was used, anteriorly via neck incision and posteriorly via the spine. The tumour was resected & iliac crest grafted along with stabilization of the cervical spine. Patient is disease free and the cervical spine stabilized with normal movements at two and half years follow up. We need to consider tumour arising from the vertebra as a differential diagnosis for any deep seated hard neck swelling in the supraclavicular region. Even low grade malignancy of this region when resected en-bloc will have a good prognosis.
为突出我院收治的一种罕见骨恶性肿瘤,其表现为锁骨上区颈部肿胀。一名30岁男性,自1年前起出现左侧颈部肿胀,6个月来左上肢麻木。颈椎磁共振成像及磁共振血管造影显示一个7.4×4.6厘米的膨胀性病变,累及C5 - C7椎体横突。由于肿瘤位于膈神经和臂丛神经深部,采用了双入路方法,前路经颈部切口,后路经脊柱。肿瘤被切除,取自体髂嵴植骨并进行颈椎固定。患者在两年半的随访中无疾病复发,颈椎稳定且活动正常。对于锁骨上区任何深部坚硬的颈部肿胀,我们需要将源于椎体的肿瘤作为鉴别诊断。即使该区域的低级别恶性肿瘤整块切除,预后也会良好。