Spiess J L, Adelstein D J, Hines J D
Department of Medicine, Case Western Reserve University, Cleveland Metropolitan General Hospital, Ohio.
Oncology. 1988;45(2):88-92. doi: 10.1159/000226539.
The clinical features, treatment, and course of 6 patients with multiple myeloma, who presented initially with spinal cord compression, are reviewed. These 6 represent 12% of all patients with myeloma seen at our institution since 1979. Eighty-three similar patients were identified from the medical literature. There are no patient characteristics predictive for this presentation. A higher than expected proportion of patents have clinically localized disease, but progression to myelomatosis is common. As these patients present without a known diagnosis of malignancy, a prompt, invasive diagnostic procedure and the immediate institution of definitive local therapy is mandatory. Despite such an aggressive approach, the prospect for significant return of neurologic function is poor. Survival does not appear to be different from that of other patients with myeloma. Unlike other malignancies, a presentation with cord compression is not inconsistent with long-term survival, although significant morbidity secondary to the resultant functional disability can be expected.
回顾了6例最初表现为脊髓压迫的多发性骨髓瘤患者的临床特征、治疗方法及病程。这6例患者占自1979年以来我院收治的所有骨髓瘤患者的12%。从医学文献中还识别出83例类似患者。没有患者特征可预测这种表现。有高于预期比例的患者存在临床局限性疾病，但进展为骨髓瘤病很常见。由于这些患者就诊时无已知恶性肿瘤诊断，必须进行快速、侵入性诊断程序并立即开始确定性局部治疗。尽管采取了这种积极的方法，但神经功能显著恢复的前景不佳。生存率似乎与其他骨髓瘤患者无异。与其他恶性肿瘤不同，脊髓压迫表现与长期生存并不矛盾，尽管可预期会因由此导致的功能残疾而出现显著的发病率。
