Franz Colin K, Dalamagkas Kyriakos, Jordan Lewis A, Spill Gayle R
1Biologics Laboratory, Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL USA.
2Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL USA.
Spinal Cord Ser Cases. 2018 Jun 26;4:55. doi: 10.1038/s41394-018-0081-8. eCollection 2018.
People with spinal cord injury (SCI) are getting older due to a combination of increased life expectancy and older age at the time of injury. This trend makes it more likely for these patients to have other chronic health conditions including cancer. Inevitably relatively rare cancers such as soft tissue sarcomas (STS), which are more common with advancing age, will occur in some SCI patients. The present case represents the first report of a limb STS in a patient with chronic paraplegia from a traumatic SCI.
We report a case of a 50-year-old right handed male with a T6 chronic, complete SCI (American Spinal Injury Association Impairment Scale A) who presented with a large mass involving his right shoulder musculature that was determined to be a high grade spindle cell sarcoma. The patient was followed closely by Physiatry over an approximately 6-month time course including prior to his tumor diagnosis, during the pre-radiation and pre-surgical planning phase, and then post-operatively for his acute inpatient rehabilitation. He was successfully discharged home to live alone in his accessible apartment complex.
This case is the first ever reported case of a person living with a traumatic SCI who subsequently developed a limb STS. In addition to its novelty, this case illustrates how health conditions such as rare cancers are presenting more often as the chronic SCI population is getting older, which creates both unique diagnostic and management challenges for cancer rehabilitation specialists.
由于预期寿命增加以及受伤时年龄较大,脊髓损伤(SCI)患者的年龄越来越大。这种趋势使得这些患者更有可能患有包括癌症在内的其他慢性健康问题。不可避免地,一些SCI患者会出现相对罕见的癌症,如软组织肉瘤(STS),随着年龄的增长,这种癌症更为常见。本病例是首例因创伤性SCI导致慢性截瘫患者发生肢体STS的报告。
我们报告一例50岁右利手男性,患有T6慢性完全性SCI(美国脊髓损伤协会损伤分级A),患者右肩部肌肉出现一个大肿块,经诊断为高级别梭形细胞肉瘤。在大约6个月的时间里,物理医学与康复科对该患者进行了密切随访,包括在肿瘤诊断之前、放疗和手术前规划阶段,以及术后的急性住院康复阶段。他成功出院,独自居住在无障碍公寓楼中。
本病例是首例报告的创伤性SCI患者继发肢体STS的病例。除了其新颖性之外,该病例还说明了随着慢性SCI患者年龄的增长,诸如罕见癌症等健康问题出现得更为频繁,这给癌症康复专家带来了独特的诊断和管理挑战。