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颈椎原发性内胚层窦血管外皮细胞瘤/孤立性纤维瘤:病例报告及文献复习。

Primary endodermal hemangiopericytoma/solitary fibrous tumor of the cervical spine: a case report and literature review.

机构信息

Department of Neurosurgery, Shengzhou People's Hospital (the First Affiliated Hospital of Zhejiang University Shengzhou Branch), Shengzhou, China.

Department of Neurosurgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

出版信息

BMC Surg. 2021 Nov 27;21(1):405. doi: 10.1186/s12893-021-01399-6.

Abstract

BACKGROUND

Hemangiopericytoma (HPC), also known as solitary fibrous tumor (SFT), is a type of soft tissue sarcoma with a special aggressive behavior. The HPC/SFT is locally aggressive with possibility of late recurrence locally or distant extraneural metastasis. The most common location of this HPC/SFT is the lower extremities. The HPC/SFT in the central nervous system (CNS) is very rare, and compared with the brain, it is rarer in the spinal region. However, clinicians also lack an overall understanding of the diagnosis of HPC/SFT in the spinal cord.

CASE PRESENTATION

In this study, we report a rare case of primary cervical spine HPC/SFT in a 53-year-old woman. Two to three weeks before admission, she experienced pain and numbness in her left upper extremity. After computerized tomography (CT) and magnetic resonance imaging (MRI), a gross total resection was performed. Obvious neurological improvement was observed postoperatively. The pain and numbness in the patient's left upper limb were relieved subsequently. We then reviewed the literature on HPC/SFT, such as its clinical presentation, imaging characteristics, treatment, and follow-up.

CONCLUSIONS

Diagnosis of HPC/SFT relies on magnetic resonance spectroscopy, enhanced CT, and MRI. Postoperative radiotherapy is strongly recommended to reduce the HPC/SFT recurrence. Immunohistochemical analysis can also help in the differential diagnosis. However; early and long-term follow-up is necessary for patients.

摘要

背景

血管外皮细胞瘤(HPC),也称为孤立性纤维瘤(SFT),是一种具有特殊侵袭性行为的软组织肉瘤。HPC/SFT 局部侵袭性强,有局部晚期复发或远处神经外转移的可能。最常见的 HPC/SFT 部位是下肢。中枢神经系统(CNS)中的 HPC/SFT 非常罕见,与大脑相比,脊髓中更为罕见。然而,临床医生对脊髓 HPC/SFT 的诊断也缺乏全面了解。

病例介绍

在本研究中,我们报告了一例罕见的 53 岁女性原发性颈椎 HPC/SFT 病例。在入院前两到三周,她出现左侧上肢疼痛和麻木。行计算机断层扫描(CT)和磁共振成像(MRI)检查后,行大体全切除。术后观察到明显的神经功能改善。随后患者左上肢的疼痛和麻木感也得到缓解。我们随后回顾了 HPC/SFT 的文献,包括其临床表现、影像学特征、治疗和随访。

结论

HPC/SFT 的诊断依赖于磁共振波谱、增强 CT 和 MRI。强烈建议术后行放疗以降低 HPC/SFT 的复发率。免疫组织化学分析也有助于鉴别诊断。然而,患者需要进行早期和长期随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2d9/8627019/72ac48510b88/12893_2021_1399_Fig1_HTML.jpg

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