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单阶段联合入路整块切除 L3 椎体软骨肉瘤:技术要点。

Single-Stage Combined Approach Sagittal En Bloc Spondylectomy for L3 Vertebral Chondrosarcoma: A Technical Note.

机构信息

Department of Surgical Oncology, Cancer Institute- Women India Association (WIA), Chennai, India.

Stanley Medical College, Chennai, India.

出版信息

World Neurosurg. 2024 Oct;190:33-37. doi: 10.1016/j.wneu.2024.05.109. Epub 2024 May 23.

Abstract

BACKGROUND

Primary malignant tumors of the spine are rare and most commonly occur in lumbar and thoracic vertebrae. We report a rare case of retroperitoneal chondrosarcoma of L3 that was managed with sagittal en bloc spondylectomy following chemoradiation.

CASE DESCRIPTION

A 26-year-old woman was evaluated for abdominal pain with contrast-enhanced computed tomography of the abdomen and pelvis, which revealed a soft tissue retroperitoneal mass arising from L3. She underwent laparotomy and biopsy, which revealed chondrosarcoma, and she received chemoradiation over a period of 28 weeks 6 days. After repeat imaging, she underwent single-stage combined approach sagittal en bloc spondylectomy of retroperitoneal chondrosarcoma of L3 with right nephrectomy and spine reconstruction. At 3-year follow-up, there was no evidence of recurrence on contrast-enhanced computed tomography of the abdomen and pelvis. She demonstrated no gait abnormality or spinal deformity.

CONCLUSIONS

Sagittal en bloc spondylectomy is a preferred surgical approach for eccentrically placed spinal tumors that offers better oncological and functional outcomes.

摘要

背景

脊柱原发性恶性肿瘤较为罕见,多发生于腰椎和胸椎。我们报告了一例罕见的 L3 腹膜后软骨肉瘤病例,患者在放化疗后接受了矢状位整块脊柱切除术治疗。

病例描述

一名 26 岁女性因腹痛接受了腹部和骨盆增强 CT 检查,结果显示 L3 处有一源于腹膜后的软组织肿块。患者接受了剖腹探查和活检,结果显示为软骨肉瘤,并接受了为期 28 周 6 天的放化疗。重复影像学检查后,患者接受了 L3 腹膜后软骨肉瘤的单阶段联合入路矢状位整块脊柱切除术,同时进行了右肾切除术和脊柱重建。在 3 年的随访中,腹部和骨盆增强 CT 未见肿瘤复发迹象。患者无步态异常或脊柱畸形。

结论

矢状位整块脊柱切除术是治疗偏心性脊柱肿瘤的首选手术方法,可获得更好的肿瘤学和功能学结果。

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