de Moraes Frederico Barra, Cardoso André Luiz Passos, Tristão Newton Antônio, Pimenta Wilson Eloy, Daher Sérgio, de Souza Carneiro Siderley, Barbosa Nathalia Parrode Machado, de Lima Malta Nayanne, Ribeiro Noara Barros
Orthopedic Doctor of the Spine Service, Hospital das Clínicas of the Universidade Federal de Goiás do HC/UFG - Goiânia, GO, Brazil.
Neurosurgeon of the Spine Service, HC/UFG - Goiânia, GO, Brazil.
Rev Bras Ortop. 2015 Nov 16;47(1):124-9. doi: 10.1016/S2255-4971(15)30356-6. eCollection 2012 Jan-Feb.
We report a rare case of primary bone liposarcoma of the lumbar spine, for which only one case has been reported. A female patient, 60 years of age, with lumbar pain and left sciatalgy for six months. In the imaging exams, a destructive tumor was found in the L4 vertebral body, and magnetic resonance imaging (MRI) revealed a tumoral lesion with T1 hiposignal and T2 hypersignal. Histological diagnosis was difficult, and immunohistochemistry confirmed the diagnosis. Surgical treatment was performed with wide ressection, spinal cord decompression, and anterior and posterior fusion of L3 to L5 complemented by radiotherapy and chemotherapy. After three years, a computed tomography (CT) scan evidenced an expansive injury in the lung. Despite its rarity, liposarcoma should be considered in the differential diagnosis of sciatica and primary tumors of the spine.
我们报告了一例罕见的腰椎原发性骨脂肪肉瘤病例，此前仅报道过一例。一名60岁女性患者，腰部疼痛伴左侧坐骨神经痛6个月。在影像学检查中，发现L4椎体有一个破坏性肿瘤，磁共振成像（MRI）显示肿瘤病变在T1加权像呈低信号，T2加权像呈高信号。组织学诊断困难，免疫组化确诊。手术治疗采用广泛切除、脊髓减压以及L3至L5前后路融合，并辅以放疗和化疗。三年后，计算机断层扫描（CT）显示肺部有一个膨胀性损伤。尽管脂肪肉瘤罕见，但在坐骨神经痛和脊柱原发性肿瘤的鉴别诊断中应考虑到它。
