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脊髓孤立性纤维瘤全切和次全切术后复发:19年后复发的病例报告及系统文献综述

Recurrence of Solitary Fibrous Tumor in the Spinal Cord Following Gross Total and Subtotal Resection: A Case Report of Recurrence 19 Years of Post-total Resection and Systematic Literature Review.

作者信息

Shidoh Satoka, Hida Kazutoshi, Oda Yoshitaka, Sasamori Toru, Shrestha Prabin, Lee Jangbo, Yamaguchi Satoshi

机构信息

Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, United States.

Department of Neurosurgery, Sapporo Azabu Neurosurgical Hospital, Sapporo, Hokkaido, Japan.

出版信息

NMC Case Rep J. 2024 Oct 24;11:297-303. doi: 10.2176/jns-nmc.2024-0145. eCollection 2024.

DOI:10.2176/jns-nmc.2024-0145
PMID:39554877
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11569836/
Abstract

Spinal cord solitary fibrous tumors (SFTs), previously known as hemangiopericytoma (HPC), represent exceedingly rare neoplasms. Strategies for their management, such as appropriate follow-up duration, remain controversial due to their propensity for recurrence despite extended periods of quiescence. We report a 51-year-old male presenting with new-onset back pain and gait disturbances, who had undergone gross total resection (GTR) of an SFT within the thoracic spinal cord 19 years ago. Magnetic resonance imaging of the thoracic spine revealed recurrent tumors at the T7 level within the spinal cord. Subsequent resection achieved GTR. A comprehensive literature review was undertaken to assess the benefits of different resection extents (gross total removal (GTR) vs. subtotal removal (STR)), adjuvant radiation therapy, and the optimal duration of postoperative follow-up. Since 1960, 46 cases, including the present one, have reported recurrent spinal SFT/HPC following GTR and STR. Statistical analyses demonstrated that neither the type of resection nor adjuvant radiation therapy significantly impacted median recurrence-free survival in this cohort. Given their unpredictable behavior, meticulous lifelong follow-up following successful resection appears crucial for managing these tumors effectively.

摘要

脊髓孤立性纤维性肿瘤(SFTs),以前称为血管外皮细胞瘤(HPC),是极为罕见的肿瘤。由于其尽管长时间静止但仍有复发倾向,其治疗策略,如适当的随访时间,仍存在争议。我们报告一例51岁男性,出现新发背痛和步态障碍,19年前曾接受胸段脊髓SFT的全切除(GTR)。胸椎磁共振成像显示脊髓内T7水平有复发性肿瘤。随后的切除实现了GTR。进行了全面的文献综述,以评估不同切除范围(全切除(GTR)与次全切除(STR))、辅助放疗以及术后最佳随访时间的益处。自1960年以来,包括本例在内,已有46例报告了GTR和STR后复发性脊柱SFT/HPC。统计分析表明,在该队列中,切除类型和辅助放疗均未对无复发生存期中位数产生显著影响。鉴于其不可预测的行为,成功切除后进行细致的终身随访对于有效管理这些肿瘤似乎至关重要。

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本文引用的文献

1
Surgical Management of Craniospinal Axis Solitary Fibrous Tumors: A Single-Institution Case Series and Comprehensive Review of the Literature.颅脊柱轴孤立性纤维肿瘤的外科治疗:单机构病例系列和文献全面回顾。
Neurosurgery. 2024 Feb 1;94(2):358-368. doi: 10.1227/neu.0000000000002692. Epub 2023 Sep 25.
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Separation Surgery and Adjuvant Carbon Ion Radiotherapy for a Recurrent Solitary Fibrous Tumor/Hemangiopericytoma: A Case Report.复发性孤立性纤维性肿瘤/血管外皮细胞瘤的分离手术及辅助碳离子放疗:一例报告
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Spinal Solitary Fibrous Tumors: An Original Multicenter Series and Systematic Review of Presentation, Management, and Prognosis.
脊柱孤立性纤维瘤:一项原始多中心研究及关于临床表现、治疗与预后的系统评价
Cancers (Basel). 2022 Jun 8;14(12):2839. doi: 10.3390/cancers14122839.
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The 2021 WHO Classification of Tumors of the Central Nervous System: a summary.2021 年世卫组织中枢神经系统肿瘤分类:概述。
Neuro Oncol. 2021 Aug 2;23(8):1231-1251. doi: 10.1093/neuonc/noab106.
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The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.PRISMA 2020 声明:系统评价报告的更新指南。
BMJ. 2021 Mar 29;372:n71. doi: 10.1136/bmj.n71.
6
The Role of Postoperative Radiotherapy in Intracranial Solitary Fibrous Tumor/Hemangiopericytoma: A Multi-institutional Retrospective Study (KROG 18-11).颅内孤立性纤维肿瘤/血管外皮细胞瘤术后放疗的作用:一项多机构回顾性研究(KROG 18-11)。
Cancer Res Treat. 2022 Jan;54(1):65-74. doi: 10.4143/crt.2021.142. Epub 2021 Mar 24.
7
An institutional review of 10 cases of spinal hemangiopericytoma/solitary fibrous tumor.10 例椎管内血管外皮细胞瘤/孤立性纤维瘤的回顾性研究。
Neurol India. 2020 Mar-Apr;68(2):448-453. doi: 10.4103/0028-3886.284374.
8
Salvage carbon ion radiotherapy for recurrent solitary fibrous tumor: A case report and literature review.复发性孤立性纤维瘤的挽救性碳离子放射治疗:一例报告及文献综述
J Orthop Surg (Hong Kong). 2020 Jan-Apr;28(1):2309499019896099. doi: 10.1177/2309499019896099.
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World Neurosurg. 2019 Mar;123:e629-e638. doi: 10.1016/j.wneu.2018.12.004. Epub 2018 Dec 13.