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胸椎巨大内生软骨瘤:一例罕见病例报告及文献复习

Large enchondroma of the thoracic spine: a rare case report and review of the literature.

作者信息

Guo Jing, Gao Ju-Zhou, Guo Lian-Jin, Yin Zhi-Xun, He Er-Xing

机构信息

Spine Surgery, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang West Road, Guangzhou, 510000, China.

Guangzhou Orthopaedic Institute, Guangzhou, China.

出版信息

BMC Musculoskelet Disord. 2017 Apr 13;18(1):155. doi: 10.1186/s12891-017-1519-z.

Abstract

BACKGROUND

Enchondroma, a subtype of chondroma, originates from the medullary cavity of the bone and produces an expansile growth pattern. Enchondroma located in the spine is rare and a few cases of large thoracic enchondroma have been reported. The authors document a rare case of large enchondroma in the thoracic spine of a 49-year-old woman, and discuss its clinical, radiological and histopathological characteristics.

CASE PRESENTATION

The patient presented with rapidly progressive and severe pain on her upper back. Magnetic resonance imaging revealed an expansile lesion at the posterior elements of T3 that was hypointense on T1-weighted images and mixed iso- to hyperintense on T2-weighted images. Administration of gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA) resulted in heterogeneous enhancement. During surgery, a large tumor of 4.2cm × 4.7cm × 2.1cm was resected along with the lamina and spinous process. Histological examination revealed that the tumor consisted of mature hyaline cartilage with typical chondrocytes, indicating that it was an enchondroma.

CONCLUSIONS

Despite its benign-growing nature, enchondroma should be examined closely for signs of enchondromatosis and enchondrosarcoma. Complete surgical resection is the treatment of choice for immediate relief of symptoms and avoidance of recurrence.

摘要

背景

内生软骨瘤是软骨瘤的一种亚型,起源于骨髓腔,呈膨胀性生长模式。位于脊柱的内生软骨瘤较为罕见,仅有少数几例关于大型胸椎内生软骨瘤的报道。作者记录了一例49岁女性胸椎大型内生软骨瘤的罕见病例,并讨论其临床、放射学和组织病理学特征。

病例介绍

患者表现为上背部迅速进展的剧痛。磁共振成像显示T3后部结构有一个膨胀性病变,在T1加权图像上呈低信号,在T2加权图像上呈等信号至高信号混合。静脉注射钆喷酸葡胺(Gd-DTPA)后呈不均匀强化。手术中,连同椎板和棘突切除了一个大小为4.2cm×4.7cm×2.1cm的大肿瘤。组织学检查显示肿瘤由成熟的透明软骨和典型的软骨细胞组成,表明为内生软骨瘤。

结论

尽管内生软骨瘤生长特性为良性,但仍应密切检查是否有内生软骨瘤病和软骨肉瘤的迹象。完整的手术切除是缓解症状和避免复发的首选治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/691b/5390427/dd4024e3869a/12891_2017_1519_Fig1_HTML.jpg

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