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一名年轻女性患者的慢性背痛：一例起源于脊髓圆锥的室管膜瘤病例。

Chronic Back Pain in a Young Female Patient: A Case of Ependymoma Originating from the Conus Medullaris.

作者信息

Asahar Siti Fairus, Malek Khasnur Abd, Zohdi Wan Najwa Wan Mohd, Peter Alan Basil

机构信息

Department of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang, Malaysia.

Department of Rehabilitation Medicine, Faculty of Medicine, Universiti Teknologi MARA, Selayang, Malaysia.

出版信息

Korean J Fam Med. 2020 Jan;41(1):68-72. doi: 10.4082/kjfm.18.0157. Epub 2020 Jan 6.

DOI:10.4082/kjfm.18.0157
PMID:31902199
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6987024/
Abstract

We present the case of a 14-year-old Malay girl with an ependymoma of the conus medullaris who presented to multiple general practitioner clinics with a 24-month history of chronic low back pain. The pain was symptomatically managed as a simple musculoskeletal pain and sciatica. Further imaging to aid diagnosis was delayed until the appearance of severe pain with neurological deficits. Magnetic resonance imaging revealed an enhancing spinal mass at L1 through L3, and histopathological investigations confirmed the grade II ependymoma according to the World Health Organization classification. She underwent gross resection of the tumor. After the surgery, she developed neurogenic urinary bladder and bowel, which required intermittent self-catheterization, intermittent enema use, and intensive physical therapy.

摘要

我们报告了一例14岁的马来女孩，患有圆锥马尾室管膜瘤，因慢性腰痛24个月，曾就诊于多家全科医生诊所。该疼痛被作为单纯的肌肉骨骼疼痛和坐骨神经痛进行对症治疗。进一步的影像学检查以辅助诊断被推迟，直到出现伴有神经功能缺损的剧痛。磁共振成像显示L1至L3水平有一个强化的脊髓肿块，组织病理学检查根据世界卫生组织分类确诊为II级室管膜瘤。她接受了肿瘤的大体切除。手术后，她出现了神经源性膀胱和肠道功能障碍，这需要间歇性自我导尿、间歇性使用灌肠剂以及强化物理治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/451ba2235640/kjfm-18-0157f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/fb369d21af09/kjfm-18-0157f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/f52aa245026a/kjfm-18-0157f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/451ba2235640/kjfm-18-0157f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/fb369d21af09/kjfm-18-0157f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/f52aa245026a/kjfm-18-0157f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1616/6987024/451ba2235640/kjfm-18-0157f3.jpg

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本文引用的文献

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Neuro Oncol. 2016 Jul;18(7):902-13. doi: 10.1093/neuonc/now016. Epub 2016 Mar 28.
2
Pediatric intramedullary spinal cord lesions: Pathological spectrum and outcome of surgery.小儿脊髓髓内病变：手术的病理谱及结果
J Pediatr Neurosci. 2015 Jul-Sep;10(3):214-21. doi: 10.4103/1817-1745.165660.
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Surgical outcomes in spinal cord ependymomas and the importance of extent of resection in children and young adults.脊髓室管膜瘤的手术结果以及儿童和青年患者中肿瘤切除范围的重要性。
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A Nonenhancing World Health Organization Grade II Intramedullary Spinal Ependymoma in the Conus: Case Illustration and Review of Imaging Characteristics.圆锥内无强化的世界卫生组织 2 级脊髓室管膜瘤：病例举例与影像学特征回顾。
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Myxopapillary ependymoma as a cause of back pain in a young male - A case report.黏液乳头型室管膜瘤致青年男性背痛1例报告
J Can Chiropr Assoc. 2013 Jun;57(2):150-5.
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An approach to interviewing adolescents.一种采访青少年的方法。
Paediatr Child Health. 2003 Nov;8(9):554-6.
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Depressive symptoms of patients using clean intermittent catheterization for neurogenic bladder secondary to spinal cord injury.脊髓损伤继发神经源性膀胱患者采用清洁间歇性导尿时的抑郁症状。
Spinal Cord. 2006 Dec;44(12):757-62. doi: 10.1038/sj.sc.3101903. Epub 2006 Jan 24.
8
Neuropathic bladder and intermittent catheterization: social and psychological impact on children and adolescents.神经源性膀胱与间歇性导尿：对儿童及青少年的社会和心理影响
Dev Med Child Neurol. 2004 Mar;46(3):168-77. doi: 10.1017/s0012162204000301.
9
Myxopapillary ependymoma of the conus medullaris and filum terminale in the pediatric age group.小儿年龄组圆锥和终丝的黏液乳头型室管膜瘤
Pediatr Neurosurg. 1997 Jan;26(1):2-7. doi: 10.1159/000121154.