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脊柱孤立性骨浆细胞瘤伴邻近椎间盘间隙受累:一例报告。

Solitary bone plasmacytoma of spine with involvement of adjacent disc space: A case report.

机构信息

Department of Orthopedics, Shandong public Health Clinical Center (Shandong Province Chest Hospital), Shandong Province, P.R. China.

Department of pathology, the 960th Hospital of Joint Logistics Support Force of PLA, Shandong Province, P. R. China.

出版信息

Medicine (Baltimore). 2021 Sep 17;100(37):e27288. doi: 10.1097/MD.0000000000027288.

Abstract

RATIONALE

Solitary bone plasmacytoma (SBP) is a rare manifestation of plasma cell tumor. Although axial skeleton is the most frequently affected site of SBP, adjacent disc space involvement is rare. Herein we report a case of SBP in thoracic vertebra with involvement of adjacent disc space.

PATIENT CONCERNS

A 57-year-old male presented with a 2-year history of intermittent back pain with activity. The patient's back pain intensity with activity was a score of 5 of the 10-point visual analog scale).

DIAGNOSES AND INTERVENTION

The patient underwent a posterior fusion procedure from T6 to T10, and an open biopsy of the vertebral lesion confirmed that final diagnosis of SBP. The patient received postoperative radiotherapy with a total of 4000 Gy to the T7-T9 vertebral levels over a 20-day period.

OUTCOMES

Following radiotherapy, the patient's pain intensity was reduced to the visual analog scale score of 1 at the 6-month follow-up.

LESSONS

SBP lacks typical clinical symptoms, and the accurate diagnosis before clinical intervention remains challenging. Due to the disc involvement, SBP often manifests as spinal infection. Hence, differential diagnosis in spinal lesions involving the disc should include SBP.

摘要

背景

孤立性骨浆细胞瘤(SBP)是浆细胞瘤的一种罕见表现。虽然轴性骨骼是 SBP 最常累及的部位,但相邻椎间盘受累很少见。在此,我们报告一例累及相邻椎间盘的胸椎体 SBP 病例。

病例介绍

一名 57 岁男性,间歇性背痛伴活动 2 年。患者的背痛活动强度为 10 分制的 5 分。

诊断和干预

患者接受了 T6 至 T10 的后路融合术,椎体病变的开放性活检证实了最终诊断为 SBP。患者接受了术后放疗,总剂量为 4000 Gy,在 20 天内分 7 次给予 T7-T9 椎体水平。

结果

放疗后,患者的疼痛强度在 6 个月随访时降至视觉模拟评分 1 分。

结论

SBP 缺乏典型的临床症状,在临床干预前的准确诊断仍然具有挑战性。由于椎间盘受累,SBP 常表现为脊柱感染。因此,涉及椎间盘的脊柱病变的鉴别诊断应包括 SBP。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0528/8447985/b4e31ca4e789/medi-100-e27288-g001.jpg

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