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脊柱副神经节瘤的临床特征及外科治疗:18例病例系列

Clinical characteristics and surgical treatment of spinal paraganglioma: A case series of 18 patients.

作者信息

Yin Mengchen, Huan Quan, Sun Zhengwang, He Shaohui, Xia Ye, Mo Wen, Ma Junming, Xiao Jianru

机构信息

Department of Orthopaedics, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China; Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

Department of Bone Tumor Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.

出版信息

Clin Neurol Neurosurg. 2017 Jul;158:20-26. doi: 10.1016/j.clineuro.2017.03.019. Epub 2017 Mar 30.

Abstract

BACKGROUND AND OBJECTIVES

Paraganglioma rarely develops in the spine. With few cases reported, little knowledge about this disease was known. The objective of this study is to illustrate the clinical features, imaging manifestations, pathological appearances and long-term outcomes of the consecutive surgeries by literature review.

METHODS

The clinical and follow-up data of 18 patients who were diagnosed of spinal paraganglioma and treated with surgeries in our hospitals from 2003 to 2014 were retrospectively analyzed.

RESULT

A total of fourteen patients radiographed of intra-spinal tumor underwent extra-capsular tumor resection. Of five patients with obvious vertebral bone damage, four cases underwent piecemeal resection, and the left one with sacral tumor underwent en bloc tumor excision. Spinal reconstruction was performed in all cases. Follow-up lasted for 16-96 months (44.1 months on average). There was no local recurrence or distant metastasis in cases without obvious bone invasion. Of those five cases with vertebral bone damage, one case suffered and survived from the repeat relapse of T1 vertebral body tumor. Local recurrence was not observed in one case with T10 vertebral tumor after tumor resection, but the tumor metastasized to T2 attachment during the follow-up and was finally eradicated by re-operation. No tumor recurrence was observed in the left three cases.

CONCLUSION

Paraganglioma, usually benign, rarely occurs. Surgical resection, especially complete surgical resection, is preferred to treat spinal paraganglioma. Chemotherapy, radiotherapy, use of octreotide and other somatostatin are selected as adjuvant therapies, but their effects remain unknown.

摘要

背景与目的

副神经节瘤很少发生于脊柱。由于报道的病例较少,人们对这种疾病了解甚少。本研究的目的是通过文献回顾阐述连续手术治疗的临床特征、影像学表现、病理特征及长期预后。

方法

回顾性分析2003年至2014年在我院诊断为脊柱副神经节瘤并接受手术治疗的18例患者的临床及随访资料。

结果

共14例脊髓内肿瘤患者行肿瘤包膜外切除术。5例有明显椎体骨质破坏的患者中,4例行分块切除术,1例骶骨肿瘤患者行肿瘤整块切除术。所有病例均行脊柱重建。随访时间为16 - 96个月(平均44.1个月)。无明显骨质侵犯的病例无局部复发或远处转移。5例椎体骨质破坏的患者中,1例T1椎体肿瘤复发并存活。1例T10椎体肿瘤切除后未观察到局部复发,但随访期间肿瘤转移至T2附件,最终通过再次手术根除。其余3例未观察到肿瘤复发。

结论

副神经节瘤通常为良性,很少发生。手术切除,尤其是完整手术切除,是治疗脊柱副神经节瘤的首选方法。化疗、放疗、使用奥曲肽及其他生长抑素作为辅助治疗,但疗效尚不清楚。

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