Sangsin Apiruk, Murakami Hideki, Shimizu Takaki, Kato Satoshi, Tsuchiya Hiroyuki
Orthopedics. 2018 Sep 1;41(5):e727-e730. doi: 10.3928/01477447-20180613-05. Epub 2018 Jun 18.
Acinic cell carcinoma metastasizing to the spine is extremely rare. The authors present a case of acinic cell carcinoma of the parotid gland with subsequent lung and spinal metastases, treated with en bloc spondylectomy. A 41-year-old man presented with a left parotid mass. After being diagnosed with acinic cell carcinoma, he underwent a total parotidectomy. Imaging studies revealed a metastatic osteoblastic lesion in the T4 vertebral body and multiple lung metastases. Total en bloc spondylectomy and reconstruction with a frozen tumor-bearing bone graft were performed to treat the T4 metastasis. Lung metastases were treated with periodic radiofrequency ablation. At the 48-month follow-up, there was no local recurrence of the lesions, and the lung metastases were controlled. The bone graft had fused with the adjacent vertebrae, and the patient had full neurological function and normal daily activities. This report indicates satisfactory long-term outcomes of total en bloc spondylectomy and reconstruction with frozen tumor-bearing bone graft in a patient with acinic cell carcinoma with spinal metastasis. It also emphasizes the benefits of radical resection of spinal metastasis even in cases with multiple organ metastases. [Orthopedics. 2018; 41(5):e727-e730.].
腺泡细胞癌转移至脊柱极为罕见。作者报告了一例腮腺腺泡细胞癌继发肺和脊柱转移的病例，采用整块脊椎切除术进行治疗。一名41岁男性因左侧腮腺肿物就诊。诊断为腺泡细胞癌后，他接受了全腮腺切除术。影像学检查显示T4椎体有转移性成骨病变及多发肺转移。为治疗T4转移灶，实施了整块脊椎切除术并采用带瘤冷冻骨移植进行重建。肺转移灶采用定期射频消融治疗。在48个月的随访中，病变无局部复发，肺转移得到控制。骨移植已与相邻椎体融合，患者神经功能完全恢复且日常活动正常。本报告表明，对于患有脊柱转移的腺泡细胞癌患者，整块脊椎切除术及带瘤冷冻骨移植重建可取得满意的长期效果。它还强调了即使在多器官转移的情况下，对脊柱转移灶进行根治性切除的益处。[《骨科》。2018年；41(5):e727 - e730。]
