Aggarwal Varun, Maheshwari Chandni, Narang Amit, Atwal Jagdeep, Bahadur Raj
Department of Neurosurgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
Department of Anaesthesia, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab, India.
World Neurosurg. 2019 Jun;126:508-512. doi: 10.1016/j.wneu.2019.03.117. Epub 2019 Mar 20.
Migratory tumors of the spinal cord are rare and can present as a missing tumor intraoperatively. This can lead to unnecessary abandonment of surgery or unnecessary laminectomies.
We present a case of migratory intradural extramedullary tumor of the spine, which was missing intraoperatively. The surgery was abandoned, and on reimaging the tumor was found to have migrated. Here we summarize a review of the literature of such cases and the lessons we learned from our experience, emphasizing the measures to prevent tumor displacement and the importance of intraoperative imaging.
Migratory schwannoma should be suspected in case of a missing lesion. Intraoperative ultrasonography and myelography use should be definitely considered where facility for intraoperative magnetic resonance imaging is not available. Preventive measures should be taken to avoid tumor migration in all routine cases of intradural extramedullary lesions.
脊髓转移性肿瘤罕见,术中可能表现为肿瘤不见。这可能导致不必要的手术放弃或不必要的椎板切除术。
我们报告一例脊柱硬膜内髓外转移性肿瘤病例,该肿瘤术中不见。手术被放弃,再次成像时发现肿瘤已移位。在此,我们总结此类病例的文献综述以及从我们的经验中学到的教训,强调预防肿瘤移位的措施以及术中成像的重要性。
若发现病变不见,应怀疑为转移性神经鞘瘤。在没有术中磁共振成像设备的情况下,应明确考虑使用术中超声和脊髓造影。在所有硬膜内髓外病变的常规病例中,都应采取预防措施以避免肿瘤移位。