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脊髓复发性孤立性纤维瘤的手术切除及术后帕唑帕尼治疗:病例报告

Resection and postoperative pazopanib for intraspinal recurrent solitary fibrous tumor: illustrative case.

作者信息

Ohno Makoto, Kawaguchi Yuki, Sugino Hirokazu, Yoshida Akihiko, Takahashi Masamichi, Yanagisawa Shunsuke, Osawa Sho, Tsuchiya Takahiro, Fujita Shohei, Narita Yoshitaka

机构信息

Departments of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.

Departments of Diagnostic Pathology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.

出版信息

J Neurosurg Case Lessons. 2024 Jul 29;8(5). doi: 10.3171/CASE24217.

Abstract

BACKGROUND

Intracranial solitary fibrous tumors (SFTs) rarely recur in the spinal space. Only 4 cases of spinal recurrence from intracranial SFT have been reported; therefore, the optimal treatment of recurrent spinal SFT remains unclear.

OBSERVATIONS

A 53-year-old woman with a history of resection of a right occipital anaplastic SFT presented with progressive back and side pain. She was diagnosed with an intradural extramedullary tumor ventral to the spinal cord at the T5-7 level. She underwent tumor resection with T5-6 laminectomy and T4 and T7 partial laminectomy. The tumor was completely removed in a piecemeal fashion using an ultrasonic aspirator with careful control of bleeding. Her symptoms quickly improved after the surgery, and she returned to normal life. The tumor was diagnosed as SFT. Pazopanib was administered postoperatively. Despite the recurrence of the intracranial tumor, the patient was alive without recurrence of the spinal tumor 14 months after resection.

LESSONS

Although rare, intracranial SFTs have a risk of spinal recurrence. Complete resection of a recurrent spinal SFT can be achieved even in the ventral location. Pazopanib could be a possible therapeutic option for preventing local tumor recurrence in the management of recurrent spinal SFT. https://thejns.org/doi/10.3171/CASE24217.

摘要

背景

颅内孤立性纤维瘤(SFT)很少在脊柱部位复发。仅有4例颅内SFT脊柱复发的病例报道;因此,复发性脊柱SFT的最佳治疗方法仍不明确。

观察

一名53岁女性,有右侧枕叶间变性SFT切除病史,出现进行性背部和侧方疼痛。她被诊断为T5 - 7节段脊髓腹侧硬膜内髓外肿瘤。她接受了T5 - 6椎板切除术及T4和T7部分椎板切除术的肿瘤切除术。使用超声吸引器小心控制出血,将肿瘤逐块完整切除。术后她的症状迅速改善,并恢复了正常生活。肿瘤被诊断为SFT。术后给予帕唑帕尼治疗。尽管颅内肿瘤复发,但患者在切除术后14个月仍存活,脊柱肿瘤未复发。

经验教训

尽管罕见,但颅内SFT有脊柱复发的风险。即使在腹侧位置,复发性脊柱SFT也可实现完全切除。帕唑帕尼可能是复发性脊柱SFT治疗中预防局部肿瘤复发的一种可能的治疗选择。https://thejns.org/doi/10.3171/CASE24217

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/784e/11301598/b45a1dffaa23/CASE24217_figure_1.jpg

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