Erol Anıl, Saidazimov Khassan, Bölük Mustafa Serdar, Yurtseven Taşkın, Biçeroğlu Hüseyin
Department of Neurosurgery, Ege University Faculty of Medicine, Izmir, TUR.
Cureus. 2024 Aug 20;16(8):e67320. doi: 10.7759/cureus.67320. eCollection 2024 Aug.
In this case report, a case of carcinoma metastasis of unknown primary mimicking spondylodiscitis in a patient with acquired immunodeficiency syndrome (AIDS) is presented. A 50-year-old AIDS patient presented with a history of mechanical falls from his own level one month ago and leg weakness for the last three days. Spinal magnetic resonance imaging (MRI) revealed a compression fracture of the T4 vertebral body, spinal cord compression, and pathology compatible with spondylodiscitis. Posterior decompression and fusion were performed, and the patient benefited. The preoperative ASIA score was C, and the postoperative ASIA score was D. The sample taken from the lesion for pathology showed carcinoma metastasis. Tumor markers and whole-body computed tomography (CT) and MRI results did not support primary malignancy. Positron emission tomography was planned for further evaluation but could not be performed due to the poor general condition of the patient. During follow-up, the patient died of sepsis due to an intensive care unit infection. As new cases of carcinoma metastasis mimicking spondylodiscitis in AIDS patients are added to the literature, we will have more information about the diagnosis and treatment process.
在本病例报告中，呈现了一例获得性免疫缺陷综合征（AIDS）患者中表现为类似脊椎椎间盘炎的不明原发癌转移病例。一名50岁的艾滋病患者，有一个月前从自己所在高度机械性跌倒的病史，且在过去三天出现腿部无力。脊柱磁共振成像（MRI）显示T4椎体压缩性骨折、脊髓受压，以及与脊椎椎间盘炎相符的病理表现。进行了后路减压和融合手术，患者从中获益。术前美国脊髓损伤协会（ASIA）评分为C级，术后ASIA评分为D级。从病变处获取的病理样本显示为癌转移。肿瘤标志物以及全身计算机断层扫描（CT）和MRI结果均不支持原发性恶性肿瘤。计划进行正电子发射断层扫描以进一步评估，但由于患者总体状况较差而未能进行。在随访期间，患者因重症监护病房感染死于败血症。随着艾滋病患者中表现为类似脊椎椎间盘炎的癌转移新病例被补充到文献中，我们将获得更多关于诊断和治疗过程的信息。
