Wu Xinjie, Qi Yingna, Yang Feng, Tan Mingsheng, Lin Jie
Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China; Graduate School of Peking Union Medical College, Beijing, P. R. China.
Department of Spine Surgery, China-Japan Friendship Hospital, Beijing, P. R. China; Graduate School of Beijing University of Chinese Medicine, Beijing, P. R. China.
World Neurosurg. 2018 Mar;111:373-376. doi: 10.1016/j.wneu.2018.01.024. Epub 2018 Jan 8.
Thymic carcinoid with spinal metastasis is an extremely rare entity. Clinically, the tumor presents either by its endocrine manifestations or by mechanical compression of surrounding structures. However, no previously published case studies have reported neck pain and neurologic deficit in the initial presentation of an atypical thymic carcinoid.
A 56-year-old man, a nonsmoker, presented with a 12-month history of intermittent neck pain and a 1-month history of progressive numbness and weakness of the right upper limb. Cervical MRI showed multiple abnormal signals and C2 soft-tissue mass intruding into the vertebral canal. Cervical CT scan showed multiple bone lesions. The diagnosis of thymic carcinoid was obtained by preoperative lymph node biopsy. The patient underwent cervical laminectomy and occipitocervical fixation. Significant alleviation of pain and neurologic improvement were achieved. The postoperative pathological examination confirmed the diagnosis of thymic carcinoid.
Neck pain and neurologic deficit could be the first presentation of thymic carcinoid with spinal metastasis. Palliative surgery is an effective method to improve quality of life in patients with thymic carcinoid with spinal metastasis.
伴有脊柱转移的胸腺类癌是一种极其罕见的疾病。临床上，该肿瘤可通过其内分泌表现或周围结构的机械性压迫来呈现。然而，此前发表的病例研究中均未报道非典型胸腺类癌初始表现为颈部疼痛和神经功能缺损。
一名56岁不吸烟男性，有12个月间歇性颈部疼痛病史及1个月右上肢进行性麻木和无力病史。颈椎MRI显示多个异常信号及C2软组织肿块侵入椎管。颈椎CT扫描显示多个骨质病变。术前淋巴结活检确诊为胸腺类癌。患者接受了颈椎椎板切除术和枕颈固定术。疼痛明显缓解，神经功能得到改善。术后病理检查证实了胸腺类癌的诊断。
颈部疼痛和神经功能缺损可能是伴有脊柱转移的胸腺类癌的首发表现。姑息性手术是提高伴有脊柱转移的胸腺类癌患者生活质量的有效方法。
