Keen Joseph, Milosavljevic Elena, Hanna George, Gospodarev Vadim, Raghavan Ravi, Ghostine Samer
Department of Neurosurgery, Loma Linda University Medical Center.
School of Medicine, Loma Linda University Medical Center.
Cureus. 2016 Nov 24;8(11):e898. doi: 10.7759/cureus.898.
Intradural extramedullary nerve root metastasis is extremely unusual with only a handful of cases reported, and it presents most commonly in the thoracic and lumbosacral regions. We report the first case of metastasis to a ventral cervical nerve root in a patient with low-grade follicular thyroid carcinoma thought to be in remission for several years. Histopathology demonstrated malignant transformation and invasion of the nerve root. This case underscores that any history of malignancy regardless of staging, grading, or remission status should raise the suspicion of metastasis as it can mimic other spine and nerve sheath tumors and represent malignant transformation. Gross total resection can be safely achieved with intraoperative neuromonitoring and result in improved function; however, treatment is likely palliative.
硬脊膜内髓外神经根转移极为罕见,仅有少数病例报道,最常见于胸段和腰骶段。我们报告了首例低级别滤泡性甲状腺癌患者发生颈前神经根转移的病例,该患者被认为已缓解数年。组织病理学显示神经根发生恶性转化并受侵犯。该病例强调,任何恶性肿瘤病史,无论分期、分级或缓解状态如何,都应引发转移的怀疑,因为它可能模仿其他脊柱和神经鞘肿瘤,并代表恶性转化。术中神经监测下可安全实现全切除,并改善功能;然而,治疗可能是姑息性的。