Cabrera-Aldana Eibar Ernesto, De la Garza Ramos Rafael, Pichardo-Bahena Raúl
Spine Surgery Service, National Rehabilitation Institute, México City, México.
Department of Neurological Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York, USA.
World Neurosurg. 2017 Apr;100:707.e11. doi: 10.1016/j.wneu.2017.01.006. Epub 2017 Jan 13.
A 40-year-old man was referred to our center with a 4-month history of progressive quadriparesis. Previous brain imaging revealed no abnormality. Magnetic resonance imaging (MRI) with contrast of the cervicothoracic spine revealed 2 heterogeneously enhancing lesions at the level of C3-C5 and T2-T4 (A); T1- and T2-weighted MRI showed hypointense and hyperintense lesions, respectively, which is characteristic of spinal cord astrocytoma (B and C). Intraoperative biopsies supported the diagnosis of glioblastoma (hypercellularity, vascular proliferation, and tumor cell palisading around necrosis) (D). Though resection was attempted, surgery was aborted due to hemodynamic instability and signal changes in neuromonitoring. The patient stabilized in the intensive care unit and experienced slight improvement in upper extremity strength. After discharge without further complications, the patient was expected to return for further adjuvant therapy/surgical planning but unfortunately passed away 1.5 months after his operation, most likely to rapid disease progression.
一名40岁男性因进行性四肢瘫痪4个月被转诊至我院。既往脑部影像学检查未发现异常。颈椎胸椎磁共振成像（MRI）增强扫描显示C3 - C5和T2 - T4水平有2个不均匀强化病灶（A）；T1加权和T2加权MRI分别显示低信号和高信号病灶，这是脊髓星形细胞瘤的特征（B和C）。术中活检支持胶质母细胞瘤的诊断（细胞增多、血管增生以及坏死周围的肿瘤细胞栅栏状排列）（D）。尽管尝试进行了切除，但由于血流动力学不稳定和神经监测中的信号变化，手术中止。患者在重症监护病房病情稳定，上肢力量略有改善。出院后无进一步并发症，预计患者会回来接受进一步的辅助治疗/手术规划，但不幸的是，患者在术后1.5个月去世，很可能是由于疾病进展迅速。
