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腰椎尤文肉瘤:罕见部位的病例报告

Lumbar spine Ewing sarcoma: A report of a rare localization.

作者信息

Al-Frejat Zyad, Esper Alia

机构信息

Department of Radiology, Damascus University, Syria.

Department of Radiology, Damascus University, Syria.

出版信息

Int J Surg Case Rep. 2024 Nov;124:110412. doi: 10.1016/j.ijscr.2024.110412. Epub 2024 Oct 3.

Abstract

INTRODUCTION

Ewing sarcoma is an aggressive tumor characterized by small round cells and diffuse CD99 positivity seen mainly in Caucasian childhood and adolescent demographics. Ewing sarcoma of spinal origin accounts for approximately 3-9 % of cases most of these cases affecting the sacrum, therefore lumbar lesions are considered quite rare.

CASE REPORT

We report a case of lumbar Ewing sarcoma in a 6-year-old female who presented with back pain and neurological symptoms of spinal compression such as lower limb weakness, constipation, and urinary retention. MRI imaging confirmed the presence of a mass located at the level of L4 and L5 vertebrates causing spinal cord compression, The patient underwent local resection of the tumor, and a biopsy was sent for histology and immunophenotyping which affirmed the diagnosis of Ewing sarcoma. The patient was referred to an oncology center for follow-up chemotherapy.

CLINICAL DISCUSSION

Ewing sarcoma is the second most common tumor of childhood and adolescence. However, a tumor arising from the spine is considered rare. It presents with localized symptoms of pain and fever but may cause neural compression symptoms. Accurate diagnosis relies mainly on radiological scans, histology, and immunohistochemical analysis.

CONCLUSION

Although Ewing sarcoma of the lumbar spine is rare, it should always be considered among pediatric populations developing localized fever and pain. Early detection is crucial to avoid undesired outcomes.

摘要

引言

尤因肉瘤是一种侵袭性肿瘤,其特征为小圆细胞以及主要在白种儿童和青少年人群中可见的弥漫性CD99阳性。脊柱起源的尤因肉瘤约占病例的3% - 9%,其中大多数病例累及骶骨,因此腰椎病变被认为相当罕见。

病例报告

我们报告一例6岁女性腰椎尤因肉瘤病例,该患者表现为背痛以及脊髓受压的神经症状,如下肢无力、便秘和尿潴留。MRI成像证实L4和L5椎体水平存在一个肿块,导致脊髓受压。患者接受了肿瘤局部切除术,并送检活检进行组织学和免疫表型分析,确诊为尤因肉瘤。患者被转诊至肿瘤中心进行后续化疗。

临床讨论

尤因肉瘤是儿童和青少年中第二常见的肿瘤。然而,起源于脊柱的肿瘤被认为很罕见。它表现为局部疼痛和发热症状,但可能导致神经受压症状。准确诊断主要依赖于放射学扫描、组织学和免疫组化分析。

结论

虽然腰椎尤因肉瘤罕见,但在出现局部发热和疼痛的儿科人群中应始终予以考虑。早期检测对于避免不良后果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09fd/11492076/5c830f149773/gr1.jpg

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