Iizuka H, Nakamura T, Kadoya S
Department of Neurosurgery, Kanazawa Medical University.
No Shinkei Geka. 1988 Sep;16(10):1199-205.
A case of spinal dumbbell shaped melanotic schwannoma was reported. A 58-year-old housewife had a 3-months history of progressive gait disturbance. She also complained of mild backache and numbness in both legs. Her family history was not remarkable. When examined on admission, October 10, 1982, mild weakness of both legs with spasticity and sensory impairment below the level of T10 dermatome without sacral sparing were evident. Her deep tendon reflexes were hyperactive on both sides and plantar responses were extensor bilaterally. Sphincteric disturbance was not significant. The function of her cranial nerves was intact. She had neither cutaneous lesions, abdominal mass nor organomegaly. Thoracic plain X-rays revealed erosion of the right side vertebral body and pedicle of the 10th thoracic vertebra. Myelography disclosed a complete block at the same level by an epidural mass. On CT-myelogram, soft tissue density mass compressing the thoracic cord was apparent in the right epidural space of the spinal canal which extended to the paravertebral region through the right intervertebral foramen. Partial destruction of the body and the right side pedicle was easily recognized. Laminectomy from T9 to T11 exposed a large extradural mass which was encapsulated, elastic soft and pigmented in nature. The tumor was dumbbell shaped and extended to the right paravertebral region through the intervertebral foramen. Costotransversectomy was performed to excise the mass entirely. Following the total removal of the tumor, internal fixation was carried out by means of Harrington instrumentation with methylmethacrylate.(ABSTRACT TRUNCATED AT 250 WORDS)
报告了一例脊髓哑铃形黑色素性施万细胞瘤。一名58岁家庭主妇有3个月进行性步态障碍病史。她还主诉轻度背痛和双腿麻木。家族史无特殊。1982年10月10日入院检查时,明显可见双腿轻度无力伴痉挛,T10皮节水平以下感觉障碍,无骶部保留。双侧深腱反射亢进,双侧跖反射为伸性。括约肌功能障碍不明显。其颅神经功能正常。她既无皮肤病变、腹部肿块,也无脏器肿大。胸部平片显示第10胸椎右侧椎体和椎弓根侵蚀。脊髓造影显示同一水平硬膜外肿块完全阻塞。CT脊髓造影显示椎管右侧硬膜外间隙有一软组织密度肿块压迫胸段脊髓,该肿块经右椎间孔延伸至椎旁区域。椎体和右侧椎弓根的部分破坏很容易辨认。T9至T11椎板切除术暴露了一个大的硬膜外肿块,该肿块有包膜,质地弹性柔软且有色素沉着。肿瘤呈哑铃形,经椎间孔延伸至右椎旁区域。进行肋横突切除术以完全切除肿块。肿瘤完全切除后,采用哈林顿器械加甲基丙烯酸甲酯进行内固定。(摘要截于250字)