Ficklscherer Andreas, Zhang Anja Ziwen, Baur-Melnyk Andrea, Knösel Thomas, Jansson Volkmar, Dürr Hans Roland
Department of Orthopedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU) , Munich, Germany.
Department of Clinical Radiology, University Hospital of Munich (LMU) , Munich, Germany.
Spinal Cord Ser Cases. 2016 Jul 7;2:16011. doi: 10.1038/scsandc.2016.11. eCollection 2016.
A 39-year-old inpatient at a tumor orthopedic department with a history of a chondrosarcoma in the scapula presented with a destructive tumorous lesion in the staging computed tomography (CT). After ambiguous results in CT-guided biopsy and an open biopsy, a surgical removal of a tumorous lesion was performed. The histological findings showed a lipoma of the spine. Intraosseous lipomas with predisposition to pathological fracture or compression of the spinal cord with neurological symptoms should be removed. We report a case in which the patient presented with complete paraplegia due to an edema in the spinal cord immediately after removal surgery. The necessity of resection of a spinal lipoma with postoperative spinal cord damage needs to be discussed. To our knowledge, this case is one of the first to demonstrate that the diagnosis of tumors of the vertebra should be carefully evaluated and possible spinal cord damage as a complication should be kept in mind upon deciding on further therapies and interventions.
一名39岁的肿瘤骨科住院患者,有肩胛骨软骨肉瘤病史,在分期计算机断层扫描(CT)中显示有破坏性肿瘤病变。在CT引导下活检和开放活检结果不明确后,对肿瘤病变进行了手术切除。组织学检查结果显示为脊柱脂肪瘤。对于易发生病理性骨折或伴有神经症状的脊髓受压的骨内脂肪瘤,应予以切除。我们报告了一例患者,在切除手术后立即因脊髓水肿出现完全性截瘫。需要讨论切除脊髓脂肪瘤并导致术后脊髓损伤的必要性。据我们所知,该病例是首批表明应仔细评估椎体肿瘤诊断,并在决定进一步治疗和干预时应牢记可能出现的脊髓损伤并发症的病例之一。