Payne J, Wolfson P, Northrup B E
J Pediatr Surg. 1986 Nov;21(11):995-6. doi: 10.1016/s0022-3468(86)80122-1.
Patients with dumbbell neuroblastoma present with a wide variety of spinal cord problems. We recently treated an infant with a large dumbbell neuroblastoma who was neurologically intact. Because a CAT scan showed a retroperitoneal mass to be abutting the right vertebral body at T12-L1, a precautionary myelogram was performed, which revealed extensive intraspinal extension. We report this case to emphasize the need to have a high index of suspicion of spinal cord involvement in light of a normal neurologic examination since, any attempt at removing the extraspinal part, first, could cause serious neurologic sequelae. We also wish to emphasize avoiding radiation therapy when the tumor has been removed grossly to lessen the development of kyphoscoliatic deformity. The infant will be routinely followed with serial VMAs and ultrasound.
哑铃型神经母细胞瘤患者会出现各种各样的脊髓问题。我们最近治疗了一名患有巨大哑铃型神经母细胞瘤的婴儿，其神经系统完好。由于计算机断层扫描显示腹膜后肿块紧邻T12-L1右侧椎体，因此进行了预防性脊髓造影，结果显示有广泛的椎管内扩展。我们报告此病例是为了强调，鉴于神经系统检查正常，仍需高度怀疑脊髓受累，因为首先切除椎管外部分的任何尝试都可能导致严重的神经后遗症。我们还希望强调，在肿瘤已大体切除的情况下，应避免放疗，以减少脊柱后凸侧弯畸形的发生。该婴儿将定期进行尿液香草扁桃酸（VMA）系列检查和超声检查。
