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病例报告:犬非典型颈髓胶质瘤术后改善的磁共振成像特征,以髓外分布为主。

Case report: Magnetic resonance imaging features with postoperative improvement of atypical cervical glioma characterized by predominant extramedullary distribution in a dog.

作者信息

Kim Junyoung, Kim Kihoon, Chung Dai Jung, Kim Yebeen, Kim Kitae, Oh Dayoung, Lee Namsoon, Choi Jihye, Yoon Junghee

机构信息

N Animal Medical Center, Seoul, Republic of Korea.

College of Veterinary Medicine and the Research Institute for Veterinary Science, Seoul National University, Seoul, Republic of Korea.

出版信息

Front Vet Sci. 2024 May 22;11:1400139. doi: 10.3389/fvets.2024.1400139. eCollection 2024.

Abstract

INTRODUCTION

Intramedullary cord tumors present diagnostic and therapeutic challenges. Furthermore, spinal cord tumors can move across compartments, making antemortem diagnosis difficult, even with advanced imaging. This report presents a rare case of a cranial cervical spinal glioma, confirmed by surgical histopathology, with postoperative improvement in a dog.

CASE DESCRIPTION

A 9-year-old female Maltese dog presented with kyphotic posture, progressive left hemiparesis, and decreased appetite. Neurological examination revealed neck pain and decreased proprioception in the left limbs along with intact deep pain perception. Two days later, the patient developed non-ambulatory tetraparesis. Magnetic resonance imaging (MRI) revealed an ovoid, well-defined mass with homogeneously marked contrast enhancement in the second cervical spinal cord that severely compressed the spinal cord. This mass was heterogeneously hyperintense on T2-weighted images and iso-to-hypointense on T1-weighted images, showing an appearance resembling the "golf-tee" and "dural tail" signs. The MRI findings suggested an intradural extramedullary tumor. Intraoperatively, a well-demarcated mass which was locally adherent to the spinal meninges was removed. Both histopathological and genomic tumor tests were indicative of a glioma. Approximately 2 weeks postoperatively, the patient's neurological signs returned to normal.

CONCLUSION

This case report describes an atypical cervical glioma with complicated MR characteristics in a dog, where MRI helped guide surgical intervention.

摘要

引言

脊髓内肿瘤带来了诊断和治疗方面的挑战。此外,脊髓肿瘤可跨区域移动,即使采用先进的影像学检查,生前诊断也很困难。本报告介绍了一例罕见的颅颈脊髓胶质瘤病例,经手术组织病理学证实,该犬术后症状有所改善。

病例描述

一只9岁雌性马尔济斯犬出现脊柱后凸姿势、进行性左半身轻瘫和食欲减退。神经学检查发现颈部疼痛、左肢本体感觉减退,而深部痛觉正常。两天后,该犬发展为非行走性四肢轻瘫。磁共振成像(MRI)显示,在第二颈椎脊髓处有一个椭圆形、边界清晰的肿块,对比增强均匀显著,严重压迫脊髓。该肿块在T2加权图像上呈不均匀高信号,在T1加权图像上呈等信号至低信号,表现出类似“高尔夫球座”和“硬膜尾”征的外观。MRI表现提示为硬膜内髓外肿瘤。术中切除了一个边界清晰、局部附着于脊髓膜的肿块。组织病理学和肿瘤基因组检测均表明为胶质瘤。术后约2周,该犬的神经症状恢复正常。

结论

本病例报告描述了一只犬的非典型颈椎胶质瘤,具有复杂的MR特征,MRI有助于指导手术干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a4c/11151459/2450cc8bf6fb/fvets-11-1400139-g001.jpg

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