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胸椎非典型侵袭性血管瘤伴胸椎脊髓病——病例报告及文献复习

Atypical Aggressive Hemangioma of Thoracic Vertebrae Associated With Thoracic Myelopathy-A Case Report and Review of the Literature.

作者信息

Timilsina Krishna, Shrestha Sandesh, Bhatta Om Prakash, Paudel Sushil, Lakhey Rajesh Bahadur, Pokharel Rohit Kumar

机构信息

Pokhara Academy of Health Sciences, Pokhara, Nepal.

Department of Orthopaedics and Trauma Surgery Tribhuvan University Teaching Hospital, Kathmandu, Nepal.

出版信息

Case Rep Orthop. 2024 Aug 13;2024:2307950. doi: 10.1155/2024/2307950. eCollection 2024.

DOI:10.1155/2024/2307950
PMID:39165484
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11335424/
Abstract

Aggressive thoracic hemangiomas are rare, benign tumors that extend into the spinal canal and cause neurological symptoms. Delayed diagnosis and treatment, due to a paucity of literature on optimal treatment strategies, can increase morbidity. This case report describes a 19-year-old male patient with aggressive thoracic hemangioma who presented with upper back pain and progressive weakness of the lower extremities. The patient underwent preoperative embolization and sclerotherapy, followed by decompression, posterior instrumentation, and stabilization. The final diagnosis was confirmed by biopsy, and there was a significant improvement in neurology after the surgical intervention. The diagnosis of rare lesions, such as aggressive hemangiomas, requires a high level of clinical suspicion and the assistance of imaging modalities in patients with features of compressive myelopathy. A combination of endovascular and surgical approaches can lead to optimal outcomes.

摘要

侵袭性胸段血管瘤是一种罕见的良性肿瘤，可延伸至椎管并引起神经症状。由于关于最佳治疗策略的文献较少，诊断和治疗延迟会增加发病率。本病例报告描述了一名19岁的男性侵袭性胸段血管瘤患者，其表现为上背部疼痛和下肢进行性无力。患者接受了术前栓塞和硬化治疗，随后进行了减压、后路内固定和稳定手术。最终诊断通过活检得以证实，手术干预后神经功能有显著改善。对于侵袭性血管瘤等罕见病变的诊断，需要高度的临床怀疑，并在具有压迫性脊髓病特征的患者中借助影像学检查手段。血管内和手术方法相结合可带来最佳治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/be01a1813e3a/CRIOR2024-2307950.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/09f067460586/CRIOR2024-2307950.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/b925f45c036f/CRIOR2024-2307950.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/fcdce91de657/CRIOR2024-2307950.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/0979ab26aecd/CRIOR2024-2307950.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/be01a1813e3a/CRIOR2024-2307950.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/09f067460586/CRIOR2024-2307950.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/b925f45c036f/CRIOR2024-2307950.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/fcdce91de657/CRIOR2024-2307950.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/0979ab26aecd/CRIOR2024-2307950.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d33c/11335424/be01a1813e3a/CRIOR2024-2307950.005.jpg

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本文引用的文献

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Conservative Management of Low Back Pain Related to an Unresectable Aggressive Sacral Hemangioma: A Case Report.无法切除的侵袭性骶骨血管瘤相关性腰痛的保守治疗：病例报告。
Am J Case Rep. 2022 Jun 23;23:e936984. doi: 10.12659/AJCR.936984.
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Thoracic spine hemangioma causing rapidly progressive myelopathy and mimicking a malignant tumor: A case report.
胸椎血管瘤致快速进展性脊髓病并酷似恶性肿瘤：1例报告
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Tubular laminectomy and percutaneous vertebroplasty for aggressive vertebral hemangioma.管状椎板切除术及经皮椎体成形术治疗侵袭性椎体血管瘤
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