Arshad Ayesha, Hanif Sheheryar, Sindhu Irfana Ishaq, Yousaf Irfan
Department of Surgical Oncology, Shaukat Khanum Cancer Hospital and Research Centre, Lahore, Pakistan.
Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore, Pakistan.
J Pak Med Assoc. 2022 Nov;72(11):2317-2319. doi: 10.47391/JPMA.4465.
Although myxopapillary ependymoma is a fairly common tumour of the lumbosacral spine, primary multi-focal myxopapillary ependymoma is a rare variant. Drop metastasis and leptomeningeal spread in the craniospinal axis is seen more frequently in the paediatric population, although it is unusual in adults. Surgical resection of the primary lesion remains the standard treatment. As per the authors' knowledge, to-date there is only one prior case in literature reporting iatrogenic spinal cord herniation with indentation after surgery for thoracolumbar spinal tumour. Here, we are discussing an unusual case of primary multi-focal ependymoma in a 16-year-old Asian boy, with drop metastasis and lepto-meningeal disease, who developed iatrogenic spinal cord herniation after the first surgery for the primary tumour. He presented to the Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH & RC), Lahore, after his first surgery. He underwent the definitive corrective surgery at SKMCH & RC where he was managed further. We discuss the management options for this patient and the lessons learned along the way.
虽然黏液乳头型室管膜瘤是腰骶部脊柱较为常见的肿瘤，但原发性多灶性黏液乳头型室管膜瘤是一种罕见的变异类型。颅脊轴的播散性转移和软脑膜播散在儿童人群中更为常见，尽管在成人中并不常见。原发性病变的手术切除仍然是标准治疗方法。据作者所知，迄今为止，文献中仅有一例先前报道的病例，即胸腰椎脊柱肿瘤手术后发生医源性脊髓疝并伴有压痕。在此，我们讨论一名16岁亚洲男孩原发性多灶性室管膜瘤的罕见病例，该病例伴有播散性转移和软脑膜病变，在首次原发性肿瘤手术后发生了医源性脊髓疝。他在首次手术后就诊于拉合尔的沙卡特·汗姆纪念癌症医院及研究中心（SKMCH & RC）。他在SKMCH & RC接受了确定性矫正手术，并在那里得到了进一步治疗。我们讨论了该患者的治疗选择以及在此过程中吸取的经验教训。
