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颈椎多发性骨髓瘤与单纯放疗

Cervical spine multiple myeloma and isolated radiotherapy.

作者信息

Belo Diogo, Reis José Hipólito, Teixeira Joaquim Cruz

机构信息

Neurosurgery Department, Centro Hospitalar Lisboa Norte (CHLN), Lisbon, Portugal.

Neurosurgery Department, Hospital CUF Infante Santo (HCIS), Lisboa, Portugal.

出版信息

J Surg Case Rep. 2021 Jan 18;2021(1):rjaa563. doi: 10.1093/jscr/rjaa563. eCollection 2021 Jan.

DOI:10.1093/jscr/rjaa563
PMID:33505656
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7816801/
Abstract

Multiple myeloma is a hematologic malignancy frequently presenting with spinal lytic lesions. The authors report the case of a patient with an extensively destructive osteolytic MM lesion in the cervical spine treated exclusively with radiotherapy. Computed tomography and magnetic resonance imaging scans showed an arrest of further progression of instability and resolution of the lytic lesion, showing signs of new bone formation. Whereas surgery should be considered for cases of spinal instability and potential neurological injury, this case demonstrates that isolated radiotherapy can be used in select cases to treat MM lesions and restore the structural integrity of the spinal elements.

摘要

多发性骨髓瘤是一种常伴有脊柱溶骨性病变的血液系统恶性肿瘤。作者报告了一例颈椎广泛破坏性溶骨性骨髓瘤病变患者，仅接受放射治疗的病例。计算机断层扫描和磁共振成像扫描显示，不稳定进一步进展得到遏制，溶骨性病变消退，出现新骨形成迹象。虽然对于脊柱不稳定和潜在神经损伤的病例应考虑手术治疗，但该病例表明，在某些特定情况下，单纯放疗可用于治疗骨髓瘤病变并恢复脊柱结构完整性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/c751629361d9/rjaa563f13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/1213f169afc2/rjaa563f1.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/e4bedf14b390/rjaa563f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/59ad3c63e05d/rjaa563f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/0d28e14bea70/rjaa563f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/9f4aeecf024c/rjaa563f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/21d2229e668e/rjaa563f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/3ac062e9cfee/rjaa563f10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/304724a87892/rjaa563f11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/cfdcaa2cb2c1/rjaa563f12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/c751629361d9/rjaa563f13.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/1213f169afc2/rjaa563f1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/c18ce4566763/rjaa563f2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/e9cbc6a8b484/rjaa563f3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/bb409f1cf499/rjaa563f4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/e4bedf14b390/rjaa563f5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/59ad3c63e05d/rjaa563f6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/0d28e14bea70/rjaa563f7.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/9f4aeecf024c/rjaa563f8.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/21d2229e668e/rjaa563f9.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/3ac062e9cfee/rjaa563f10.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/304724a87892/rjaa563f11.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/cfdcaa2cb2c1/rjaa563f12.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/52e2/7816801/c751629361d9/rjaa563f13.jpg

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Spine Instability Neoplastic Score: agreement across different medical and surgical specialties.脊柱不稳定肿瘤评分：不同医学和外科专业之间的一致性。
Spine J. 2016 May;16(5):591-9. doi: 10.1016/j.spinee.2015.10.006. Epub 2015 Oct 22.
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Multiple myeloma of the cervical spine: treatment strategies for pain and spinal instability.颈椎多发性骨髓瘤：疼痛与脊柱不稳定的治疗策略
J Neurosurg Spine. 2006 Aug;5(2):140-5. doi: 10.3171/spi.2006.5.2.140.
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