Sánchez-Calderón Mauricio Daniel, Ochoa-Cacique Diego, Medina Carrillo Oscar, García González Ulises, Vicuña González Rosa María, Bravo Reyna Carlos Cesar, Guerra-Mora José Raúl
Department of Neurology and Neurosurgery, South Central High Specialty Hospital, Pemex, Mexico.
Neurology and Neurosurgery Department, South Central High Specialty Hospital, Pemex, Mexico.
Int J Surg Case Rep. 2018;51:328-330. doi: 10.1016/j.ijscr.2018.09.023. Epub 2018 Sep 18.
Brown tumors are non-neoplastic, expansive bone lesions that occur only in the setting of hyperparathyroidism. The most usual localization of brown tumors is in mandible, ribs and large bones. In cervical spine, to date, there are only 11 cases reported. The aim of this work is to report the case of a patient with Wegener´s granulomatosis with secondary end stage renal failure who developed a brown tumor in C4 vertebra.
A 25-year-old woman with an history of 2 months of worsening cervicalgia without history of trauma. She complained about progressive neck pain with irradiation to both shoulders and right arm paresthesias, spontaneous fracture or brown spinal cord tumor were suspected. She presented cervical spine instability, was managed with corpectomy of C4 and biopsy.
The initial suspicion of this disease must be since the first clinician contact of the patient and with the past medical history of end stage renal failure plus recent neurologic manifestations. The aim of neurosurgical management of these patients is to promote spinal stability and release spinal cord and nerve roots to eliminate risk of neurological deficits.
The importance of the prompt diagnosis of the brown tumor is to establish a multidisciplinary management to prevent progression, neurologic complications and sequelae despite its benign behavior.
棕色瘤是非肿瘤性、膨胀性骨病变,仅发生于甲状旁腺功能亢进的情况下。棕色瘤最常见的部位是下颌骨、肋骨和大骨。迄今为止,颈椎部位仅有11例报道。本文旨在报告1例韦格纳肉芽肿继发终末期肾衰竭患者,其在C4椎体发生棕色瘤的病例。
一名25岁女性,有2个月颈部疼痛加重病史,无外伤史。她主诉颈部疼痛进行性加重,放射至双肩,右臂有感觉异常,怀疑有自发性骨折或棕色脊髓瘤。她出现颈椎不稳,接受了C4椎体次全切除及活检。
从患者首次就诊及既往终末期肾衰竭病史加上近期神经系统表现开始,就必须初步怀疑该病。对这些患者进行神经外科治疗的目的是促进脊柱稳定,解除脊髓和神经根压迫,消除神经功能缺损风险。
尽管棕色瘤表现为良性,但及时诊断的重要性在于建立多学科治疗方案,以防止病情进展、神经并发症及后遗症。