Shimizu Takaki, Murakami Hideki, Sangsin Apiruk, Demura Satoru, Kato Satoshi, Shinmura Kazuya, Yokogawa Noriaki, Oku Norihiro, Kitagawa Ryo, Tsuchiya Hiroyuki
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kanazawa University, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
J Med Case Rep. 2018 Oct 16;12(1):300. doi: 10.1186/s13256-018-1844-3.
Spinal metastases of gastrointestinal stromal tumors are rare; however, the incidence has been increasing since the introduction of tyrosine kinase inhibitors, which have improved overall survival. Due to the rarity of cases, there are no treatment guidelines for spinal metastases of gastrointestinal stromal tumors. We describe a patient who underwent spinal metastasectomy for a rectal gastrointestinal stromal tumor; we further provide a review of all cases of gastrointestinal stromal tumors with spinal metastases.
A 51-year-old Japanese man who had undergone resection for a rectal gastrointestinal stromal tumor was diagnosed with L3 vertebral metastasis 10 years after surgery. As there were no metastases to vital organs, an en bloc corpectomy of the L3 vertebral body, using bilateral retroperitoneal approaches, was performed to achieve local cure and to prevent neural compression. A 3-year follow-up showed no local recurrence or new metastases; he had full neurological function.
Spinal metastasectomy can be an effective treatment for solitary spinal metastases of gastrointestinal stromal tumors.
胃肠道间质瘤的脊柱转移罕见;然而,自酪氨酸激酶抑制剂应用以来,其发病率一直在上升,酪氨酸激酶抑制剂改善了总体生存率。由于病例罕见,尚无胃肠道间质瘤脊柱转移的治疗指南。我们描述了一名因直肠胃肠道间质瘤接受脊柱转移瘤切除术的患者;我们还对所有胃肠道间质瘤脊柱转移病例进行了综述。
一名51岁的日本男性,曾接受直肠胃肠道间质瘤切除术,术后10年被诊断为L3椎体转移。由于重要器官无转移,采用双侧腹膜后入路对L3椎体进行整块切除,以实现局部治愈并预防神经受压。3年随访显示无局部复发或新的转移;他的神经功能完全正常。
脊柱转移瘤切除术对于胃肠道间质瘤的孤立性脊柱转移可能是一种有效的治疗方法。