Ravanpay Ali C, Fromm Jonathan R, Edlefsen Kerstin L, Martin Paul, Chesnut Randal
Clin Neuropathol. 2018 Jan/Feb;37(1):28-35. doi: 10.5414/NP301038.
In this report, we present a 53-year-old woman with primary mast cell sarcoma of the thoracic spine vertebrae. Mast cell sarcoma is an aggressive and rare cancer. To date, no cases of primary mast cell sarcoma have been reported in the spinal vertebrae. The patient initially presented with a 1-month history of pelvic and abdominal pain. Inconclusive gynecological evaluation resulted in a CT of the abdomen and pelvis, demonstrating a destructive lesion centered at the 11 thoracic vertebral body. The patient underwent a two-stage spine operation for T11 corpectomy and T7-L3 posterior spinal fusion. Histopathological, immunohistochemical, and flow cytometry studies of the resection specimens showed the tumor to be mostly composed of CD117-positive and mast cell tryptase-positive cells with features consistent with mast cell sarcoma. This is the first reported case of primary vertebral mast cell sarcoma, which may mimic other destructive lesions of the spine including osteomyelitis, vertebral tuberculosis, or plasmacytoma. .
在本报告中,我们介绍了一名53岁的女性,患有胸椎原发性肥大细胞肉瘤。肥大细胞肉瘤是一种侵袭性且罕见的癌症。迄今为止,尚未有脊椎原发性肥大细胞肉瘤的病例报道。该患者最初表现为1个月的盆腔和腹痛病史。妇科评估结果不明确,遂进行腹部和盆腔CT检查,显示以第11胸椎椎体为中心的破坏性病变。患者接受了两阶段脊柱手术,包括T11椎体次全切除术和T7-L3后路脊柱融合术。对切除标本进行的组织病理学、免疫组织化学和流式细胞术研究表明,肿瘤主要由CD117阳性和肥大细胞类胰蛋白酶阳性细胞组成,其特征与肥大细胞肉瘤一致。这是首例报道的原发性椎体肥大细胞肉瘤病例,该病例可能会被误诊为包括骨髓炎、脊椎结核或浆细胞瘤在内的其他脊柱破坏性病变。