Pu Feifei, Wang Baichuan, Liu Jianxiang, Chen Fengxia, Shao Zengwu
Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China.
Department of Medical Oncology, General Hospital of The Yangtze River Shipping, Wuhan, Hubei, 430000, People's Republic of China.
Eur Spine J. 2017 May;26(Suppl 1):95-99. doi: 10.1007/s00586-016-4877-6. Epub 2016 Nov 29.
Case report.
We present a rare case of a giant chordoma in the thoracolumbar spine and review the current literature. We describe its complicated clinical progression, hoping to shed light on the clinical management of this complex tumor.
We present a previously healthy 41-year-old man who experienced progressive low back pain at T10-L2 for the past 2 years. A giant tumor was detected on magnetic resonance imaging, and aspiration biopsy was used to obtain a definite pathological diagnosis. The postoperative pathology confirmed that it was a chordoma. He underwent complete resection of the tumor and internal fixation of the vertebral bodies, which is a good way to control recurrence and preserve stability.
Histopathology confirmed the tumor was a chordoma via immunohistochemical study of both the biopsy sample and the surgically resected tissues. There has been no recurrence or metastasis at the 30-month postsurgery radiographic examination. The internal fixation has remained stable.
Primary chordoma in the thoracolumbar spine is extremely rare. The treatment is difficult because the current literature is sparse and patients are rare. Complete resection and internal fixation are effective for reducing recurrences and metastasis.
病例报告。
我们报告一例罕见的胸腰椎巨大脊索瘤病例并回顾当前文献。我们描述其复杂的临床病程,希望能为这种复杂肿瘤的临床管理提供启示。
我们介绍一名既往健康的41岁男性,在过去2年中经历了T10 - L2节段的进行性下背痛。磁共振成像检测到一个巨大肿瘤,通过穿刺活检获得明确的病理诊断。术后病理证实为脊索瘤。他接受了肿瘤的完整切除及椎体的内固定,这是控制复发和保持稳定性的良好方法。
组织病理学通过对活检样本和手术切除组织的免疫组化研究证实肿瘤为脊索瘤。术后30个月的影像学检查未发现复发或转移。内固定保持稳定。
胸腰椎原发性脊索瘤极为罕见。由于当前文献稀少且患者罕见,治疗具有挑战性。完整切除和内固定对于减少复发和转移是有效的。