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颈椎动脉包绕的巨细胞瘤的前后联合手术入路及术后药物治疗的多模态管理:一个技术病例报告。

Multimodal Management of Combined Posterior and Anterior Surgical Approach and Postoperative Pharmacological Therapy for Giant Cell Tumor of the Cervical Spine Encasing the Vertebral Artery: A Technical Case Report.

机构信息

Department of Neurosurgery, Osaka Medical and Pharmaceutical University.

Department of Neurosurgery, Kano General Hospital.

出版信息

Neurol Med Chir (Tokyo). 2022 Sep 15;62(9):438-443. doi: 10.2176/jns-nmc.2022-0158. Epub 2022 Aug 27.

Abstract

Giant cell tumor (GCT) of bone is essentially benign but locally aggressive, and the rate of local recurrence is high when the resection is not enough. En bloc resection is recommended as an ideal solution for GCT to decrease the risk of local recurrence, but it remains challenging for cervical GCT. In this technical case report, we present a case of extensively infiltrating GCT of the cervical spine completely encasing the vertebral artery (VA) on one side. The tumor was distributed to layers A-D, sectors 3-8 based on the Weinstein-Boriani-Biagini staging. Combined posterior and anterior surgical approach for the cervical spine was successfully performed and followed by postoperative adjuvant pharmacological therapy. This kind of multimodal management may be one of the solutions for advanced cervical GCT.

摘要

骨巨细胞瘤(GCT)本质上是良性的,但具有局部侵袭性,当切除不充分时,局部复发率很高。整块切除术被推荐为 GCT 的理想解决方案,以降低局部复发的风险,但对于颈椎 GCT 仍然具有挑战性。在本技术病例报告中,我们报告了一例广泛浸润性颈椎 GCT,该肿瘤完全包裹在一侧椎动脉(VA)上。根据 Weinstein-Boriani-Biagini 分期,肿瘤分布在 A-D 层和 3-8 区。成功地进行了颈椎后路和前路联合手术,随后进行了术后辅助药物治疗。这种多模式管理可能是治疗晚期颈椎 GCT 的方法之一。

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