Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan; Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan.
World Neurosurg. 2019 Aug;128:289-294. doi: 10.1016/j.wneu.2019.05.065. Epub 2019 May 15.
Ganglioneuroma is a well-differentiated benign tumor that develops from the ganglion cells of the posterior mediastinum, retroperitoneum, cervical spine, and adrenal glands. The paravertebral body, in which the sympathetic trunk exists, is a common tumor site, and tumor sometimes invades the spinal canal through the intervertebral foramen. There have been no reports regarding tumors with intradural and extradural continuity. We report a paravertebral ganglioneuroma extending between the intradural and extradural spaces and its surgical treatment.
A 33-year-old man was admitted to the hospital with progressive left lower limb numbness. A dumbbell-type tumor progressing to the spinal canal via the left intervertebral foramen from the paravertebral body at L1-2 was detected, and intradural calcified lesions were found. Pathologic examination of a computed tomography-guided biopsy sample revealed a ganglioglioma. The extradural tumor was removed; however, the left lower limb pain gradually worsened. As complete block was observed on myelography, the intradural tumor was removed 8 months later. Intraoperative findings revealed that the intradural and extradural tumors were continuous through the L1 nerve root.
This is the first known reported case of paravertebral ganglioneuroma presenting in continuity between the intradural and extradural spaces.
神经节细胞瘤是一种分化良好的良性肿瘤,起源于后纵隔、腹膜后、颈椎和肾上腺的神经节细胞。椎旁体是交感干存在的部位,是常见的肿瘤部位,肿瘤有时通过椎间孔侵入椎管。目前尚无关于具有硬膜内和硬膜外连续性的肿瘤的报道。我们报告了一例发生于硬膜内和硬膜外间隙之间的椎旁神经节细胞瘤及其手术治疗。
一名 33 岁男性因左下肢进行性麻木入院。发现从 L1-2 椎旁体通过左侧椎间孔向椎管进展的哑铃型肿瘤,并存在硬膜内钙化病变。CT 引导下活检的病理检查显示为神经节胶质瘤。切除了硬膜外肿瘤,但左下肢疼痛逐渐加重。由于脊髓造影显示完全阻塞,8 个月后再次切除硬膜内肿瘤。术中发现硬膜内和硬膜外肿瘤通过 L1 神经根连续。
这是首例已知的发生于硬膜内和硬膜外间隙之间连续性的椎旁神经节细胞瘤病例。