Orthopaedic Surgery, Koyama Memorial Hospital, Ibaraki, Japan.
Department of Orthopaedic Surgery, Kyorin University School of Medicine, Tokyo, Japan.
J Spinal Cord Med. 2022 Mar;45(2):320-323. doi: 10.1080/10790268.2020.1739380. Epub 2020 Mar 23.
Metastatic intradural extramedullary spinal cord tumors are extremely rare. A 76-year-old woman presented with intractable neck pain. Three years earlier, she had been treated for ovarian cancer with bilateral salpingo-oophorectomy. A year later, she underwent resection of a brain metastasis. Magnetic resonance imaging (MRI) showed an encapsulated intradural extramedullary mass at C4-C5. C4-C5 hemilaminectomy, tumor resection, and biopsy were performed. Histological examination of the resection revealed an adenocarcinoma. After surgery, her intolerable neck-shoulder pain was fully resolved, and she had no difficulties with daily living activities. However, two months later, she underwent gamma knife radiosurgery for the recurrent metastatic brain tumor, and four months later, she died from cachexia. Although cases of metastatic intradural extramedullary spinal tumors from ovarian cancer are extremely rare, their possibility should be considered in the differential diagnosis. A history of brain metastases and enhancement on T1-weighted MRI were helpful for making an accurate diagnosis.
椎管内髓外硬膜转移瘤极为罕见。一名 76 岁女性因难治性颈部疼痛就诊。3 年前,她因卵巢癌接受了双侧输卵管卵巢切除术。一年后,她接受了脑转移瘤切除术。磁共振成像(MRI)显示 C4-C5 处有一个包膜内髓外硬膜肿块。进行了 C4-C5 半椎板切除术、肿瘤切除术和活检。切除组织的组织学检查显示为腺癌。手术后,她难以忍受的颈肩部疼痛完全缓解,日常生活活动也没有困难。然而,两个月后,她因复发性脑转移瘤接受了伽玛刀放射外科治疗,四个月后,她因恶病质去世。尽管卵巢癌椎管内髓外硬膜转移瘤的病例极为罕见,但在鉴别诊断中应考虑到这种可能性。脑转移病史和 T1 加权 MRI 增强有助于做出准确诊断。