Chen Ruiqi, Xiao Anqi, Xing Lu, You Chao, Liu Jiagang
Department of Neurosurgery, West China Hospital Department of Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2017 Mar;96(11):e6327. doi: 10.1097/MD.0000000000006327.
This is the first case report about a thoracic intraspinal schwannoma in twin pregnancy with aggressive clinical presentation.
A 21-year-old woman presented with a 2-month history of back pain and slight lower extremity numbness and weakness, and her symptoms were misdiagnosed as normal reactions to pregnancy until she progressed to complete paralysis and incontinence within 2 weeks. She was then confirmed to have thoracic intraspinal schwannoma through MRI.
Surgery was performed using a unilateral hemilaminectomy approach with a comfortable lateral position during operation. The patient exhibited significant improvements in sensation and muscle strength after surgery. She delivered 2 healthy baby girls by eutocia in her 38th week of pregnancy.
The diagnosis of this disease and the 4 possible mechanisms of its aggravated clinical presence are discussed. Intraspinal schwannomas during pregnancy are rare but may cause critical consequences for both the mother and the fetus. Timely diagnosis and multidisciplinary treatment by obstetricians, anesthesiologists, surgeons, oncologists, and neonatologists are essential for the clinical management of this disease.
这是首例关于双胎妊娠合并具有侵袭性临床表现的胸段脊髓内神经鞘瘤的病例报告。
一名21岁女性，有2个月背痛病史，伴轻微下肢麻木和无力，其症状一直被误诊为妊娠正常反应，直到2周内病情进展至完全瘫痪和大小便失禁。随后通过磁共振成像（MRI）确诊为胸段脊髓内神经鞘瘤。
手术采用单侧半椎板切除术，术中取舒适侧卧位。术后患者感觉和肌力有显著改善。她在妊娠第38周顺产2名健康女婴。
讨论了该疾病的诊断及其临床表现加重的4种可能机制。妊娠期脊髓内神经鞘瘤罕见，但可能对母亲和胎儿都造成严重后果。产科医生、麻醉医生、外科医生、肿瘤学家和新生儿科医生的及时诊断和多学科治疗对于该疾病的临床管理至关重要。
