Department of Radiology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Department of Pathology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
Childs Nerv Syst. 2021 Dec;37(12):3913-3917. doi: 10.1007/s00381-021-05145-4. Epub 2021 Apr 24.
Synovial sarcoma (SS) is a rare mesenchymal malignant tumor. SS of the spine or retroperitoneum is an extremely rare site. Approximately 30% cases show focal calcifications on radiographs and computed tomography (CT) images, while extensive calcification rarely occurs. We presented a case of SS involving the spinal canal and paraspinal muscle and retroperitoneum, which showed extensive calcification on CT.
The present report describes the case of a 13-year-old girl suffering from a tumor in the spinal canal and paraspinal muscle and retroperitoneum with extensive calcification on CT. The patient underwent lumbar and retroperitoneal giant tumor resection, lumbar decompression, and spinal tumor resection with a small tumor remnant remaining in the paravertebral region. Histological examination and genetic testing after surgery confirmed synovial sarcoma. After surgery, the patient refused local radiotherapy but agreed to receive chemotherapy. After 4 months of follow-up, her condition was basically stable, and the pain in her left lower limb disappeared. The residual tumor was not increased.
Extensive calcification of SS is rare. The possibility of synovial sarcoma should be considered in those who show extensive calcification in the spinal canal and paraspinal muscle and retroperitoneum on CT. For cases that cannot be completely resected, adjuvant chemotherapy can control the residual tumor in the short term. In addition, the long-term effects need to be observed.
滑膜肉瘤(SS)是一种罕见的间叶性恶性肿瘤。脊柱或腹膜后 SS 是一种极其罕见的部位。大约 30%的病例在 X 线和计算机断层扫描(CT)图像上显示局灶性钙化,而广泛钙化则很少发生。我们报告了一例累及椎管和椎旁肌肉及腹膜后腔的 SS,CT 显示广泛钙化。
本报告描述了一例 13 岁女孩患有椎管和椎旁肌肉及腹膜后腔的肿瘤,CT 显示广泛钙化。患者接受了腰椎和腹膜后巨大肿瘤切除术、腰椎减压术和脊柱肿瘤切除术,椎旁区域仍残留少量肿瘤。术后组织病理学检查和基因检测证实为滑膜肉瘤。术后,患者拒绝局部放疗,但同意接受化疗。随访 4 个月后,患者病情基本稳定,左下肢疼痛消失,残留肿瘤无增大。
SS 的广泛钙化较为罕见。对于 CT 显示椎管和椎旁肌肉及腹膜后广泛钙化的患者,应考虑滑膜肉瘤的可能性。对于无法完全切除的病例,辅助化疗可在短期内控制残留肿瘤。此外,还需要观察长期效果。