巨大的胸段脊髓脂肪瘤的不常见表现。
Unusual presentation of a giant thoracic spinal cord lipoma.
机构信息
Department of Neurosurgery, King Fahad Specialist Hospital Dammam (KFSHD), Dammam, Saudi Arabia.
Department of Neurology, National Neurosciences Institute, King Fahad Medical City, Riyadh, Saudi Arabia.
出版信息
Spinal Cord Ser Cases. 2022 Mar 28;8(1):35. doi: 10.1038/s41394-022-00489-8.
INTRODUCTION
Non-dysraphic intradural spinal cord lipomas are rare, and true intramedullary cervical-thoracic lipomas are extremely rare. Spinal lipomas usually present with chronic, progressive myelopathic features. Unlike dysraphic lipomas, which are usually located in the lumbo-sacral region, non-dysraphic lipomas are usually located in the cervical or thoracic spine.
CASE PRESENTATION
We present an unusual case of a 21-year-old female who presented with four months of severe back pain, progressive spasticity, and weakness in the lower limbs. Magnetic resonance imaging (MRI) revealed a T1- and T2-hyperintense lesion between D4 and D6.
DISCUSSION
This fatty intramedullary lesion had undergone evolution and a possible hemorrhagic infarct and cord compression. The patient underwent an urgent dorsal laminoplasty and total resection of this lesion, which histopathology indicated was a fibrous lipoma. Total resection is possible in such cases if a micro-surgical technique that includes neurophysiological monitoring is used.
简介
非脊膜内脊髓脂肪瘤罕见，真正的颈胸髓内脂肪瘤则极为罕见。脊髓脂肪瘤通常表现为慢性、进行性脊髓病特征。与通常位于腰骶部的脊膜内脂肪瘤不同，非脊膜内脂肪瘤通常位于颈段或胸段脊柱。
病例介绍
我们报告了一例不常见的病例，一名 21 岁女性，表现为四个月的严重背痛、进行性痉挛和下肢无力。磁共振成像（MRI）显示 D4 至 D6 之间有 T1 和 T2 高信号病变。
讨论
这个脂肪性的髓内病变已经发生了演变，可能发生了出血性梗死和脊髓压迫。患者接受了紧急的背部椎板切开术和该病变的全切除，组织病理学表明这是一个纤维脂肪瘤。如果使用包括神经生理学监测的显微外科技术，此类病例可以进行全切除。
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