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以腰椎转移为首发表现的恶性黑色素瘤切除与重建:1例病例报告

Malignant melanoma resection and reconstruction with the first manifestation of lumbar metastasis: A case report.

作者信息

Guo Zi-Xuan, Zhao Xue-Lin, Zhao Zi-Yi, Zhu Qing-Yan, Wang Zi-Ying, Xu Meng

机构信息

Graduate School, Medical School of Chinese PLA, Beijing 100853, China.

Department of Orthopedics, The Forth Medical Center of PLA General Hospital, Beijing 100037, China.

出版信息

World J Clin Cases. 2023 May 26;11(15):3571-3577. doi: 10.12998/wjcc.v11.i15.3571.

Abstract

BACKGROUND

Malignant melanoma (MM) has shown an increasing incidence worldwide, and a potential to metastasize to almost any part of the body. Clinically, MM with bone metastasis as the initial manifestation is extremely rare. Spinal metastatic MM can cause spinal cord or nerve root compression, resulting in severe pain and paralysis. Currently, the primary clinical treatments for MM are surgical resection in conjunction with chemotherapy, radiotherapy, and immunotherapy.

CASE SUMMARY

Here, we report the case of a 52-year-old male who presented to the clinic with progressive low back pain and limited nerve function. No primary lesion or spinal cord compression was detected from computed tomography and magnetic resonance imaging of the lumbar vertebrae and positron emission tomography scan. A lumbar puncture biopsy confirmed the diagnosis of lumbar spine metastatic MM. Following surgical resection, the patient's quality of life improved, symptoms were relieved, and comprehensive treatment was initiated, which prevented recurrence.

CONCLUSION

Spinal metastatic MM is clinically rare, and may cause neurological symptoms, including paraplegia. Currently, the clinical treatment plan consists of surgical resection in combination with chemotherapy, radiotherapy, and immunotherapy.

摘要

背景

恶性黑色素瘤(MM)在全球范围内的发病率呈上升趋势,并且有转移至身体几乎任何部位的可能性。临床上,以骨转移为初始表现的MM极为罕见。脊柱转移性MM可导致脊髓或神经根受压,引发剧痛和瘫痪。目前,MM的主要临床治疗方法是手术切除联合化疗、放疗和免疫治疗。

病例摘要

在此,我们报告一例52岁男性患者,其因进行性下腰痛和神经功能受限前来就诊。腰椎计算机断层扫描、磁共振成像及正电子发射断层扫描均未发现原发灶或脊髓受压情况。腰椎穿刺活检确诊为腰椎转移性MM。手术切除后,患者生活质量改善,症状缓解,并开始进行综合治疗,预防了复发。

结论

脊柱转移性MM临床罕见,可能导致包括截瘫在内的神经症状。目前,临床治疗方案包括手术切除联合化疗、放疗和免疫治疗。

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