胸椎硬膜内髓外结核瘤——一例截瘫罕见病例报告
Intradural extramedullary tuberculoma of the thoracic spine - A rare case report of paraparesis.
作者信息
Kangabam Boris, Amataleima Thokchom, Amitkumar Mayanglambam, Umesh Takhelmayum
机构信息
Department of Surgery, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.
Department of Neurosurgery, Jawaharlal Nehru Institute of Medical Sciences, Imphal, Manipur, India.
出版信息
Surg Neurol Int. 2021 Apr 8;12:136. doi: 10.25259/SNI_197_2021. eCollection 2021.
BACKGROUND
Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an extremely rare form of spinal tuberculosis (TB) that is believed to be due to a host's immune reaction against the protein derivatives.
CASE DESCRIPTION
A 25-year-old male with human immunodeficiency virus, hepatitis C virus, and disseminated TB on antitubercular therapy for the past 8 months, presented with paraplegia of 2 months duration. When the MRI spine revealed multiple peripheral rim enhancing intradural extramedullary lesions from T6 to T8 and dorsally from T10 to T11, the patient was diagnosed with IETSC. At surgery, we countered cystic lesions adherent to the dura and the spinal cord, containing a whitish material. Postoperatively, the patient showed clinical improvement in motor power and sensation.
CONCLUSION
Intradural extramedullary spinal tuberculomas in patients with a history of TB and spinal cord compression, although rare, should be considered among the differential diagnoses.
背景
脊髓硬膜内髓外结核瘤（IETSC）是一种极为罕见的脊柱结核形式，据信是由于宿主对蛋白质衍生物的免疫反应所致。
病例描述
一名25岁男性，感染人类免疫缺陷病毒、丙型肝炎病毒，过去8个月一直在接受抗结核治疗，患有播散性结核病，出现了持续2个月的截瘫症状。当脊柱MRI显示从T6至T8以及从T10至T11背侧有多个周边环形强化的硬膜内髓外病变时，该患者被诊断为IETSC。手术中，我们遇到了与硬脑膜和脊髓粘连的囊性病变，其中含有白色物质。术后，患者的运动能力和感觉在临床上有所改善。
结论
有结核病史且伴有脊髓压迫的患者出现硬膜内髓外脊柱结核瘤，尽管罕见，但在鉴别诊断时应予以考虑。
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