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颈椎内生软骨瘤:罕见性、复发性及长期监测的重要性

Spinal Enchondromas in the Cervical Spine: Rarity, Recurrence and the Importance of Long-Term Surveillance.

作者信息

Patel Nevish, Macwan Anson Albert, Modi Yashvi, Modi Hitesh

机构信息

Department of Spine Surgery, Zydus Hospitals and Healthcare Research Private Limited, Ahmedabad, Gujarat, India.

出版信息

J Orthop Case Rep. 2024 Dec;14(12):22-26. doi: 10.13107/jocr.2024.v14.i12.5004.

Abstract

INTRODUCTION

Chondromas are benign cartilaginous tumors classified into periosteal chondromas and enchondromas. While periosteal chondromas grow on the bone surface, enchondromas develop within the medullary cavity. Enchondromas constitute 4-8% of all bone tumors, with spinal enchondromas being exceptionally rare, particularly in the cervical region. Despite their benign nature, spinal enchondromas can cause significant clinical symptoms and have the potential for recurrence or malignant transformation.

CASE REPORT

A 14-year-old female presented with a swelling on the posterior aspect of her neck, accompanied by dull, aching pain radiating into the right upper limb, and muscle weakness assessed at IV/V. Imaging studies, including computed tomography (CT) and magnetic resonance imaging, revealed a lobulated lesion in the right lamina of the C4 vertebra extending to C5, causing spinal cord and nerve root indentation. The patient underwent a C4-C5 laminectomy with complete tumor excision. Histopathological examination confirmed the diagnosis of enchondroma.

FOLLOW-UP AND OUTCOMES: At 6 months, the patient experienced complete resolution of pain and significant improvement in neurological symptoms. Follow-up CT scans at 3 years and at 10 years did not exhibit any recurrence, and the patient remained symptom-free throughout the follow-up period.

CONCLUSION

This case highlights the successful long-term outcome following the surgical resection of a cervical spine enchondroma, demonstrating that aggressive surgical intervention can lead to sustained symptom-free outcomes. The 10-year follow-up provides valuable insight into the long-term prognosis of cervical spine enchondromas, emphasizing the importance of early and complete surgical resection along with extended surveillance.

摘要

引言

软骨瘤是良性软骨肿瘤,分为骨膜软骨瘤和内生软骨瘤。骨膜软骨瘤生长在骨表面,而内生软骨瘤在骨髓腔内发展。内生软骨瘤占所有骨肿瘤的4 - 8%,脊柱内生软骨瘤极为罕见,尤其是在颈椎区域。尽管其本质为良性,但脊柱内生软骨瘤可引起显著的临床症状,并有可能复发或恶变。

病例报告

一名14岁女性,颈部后方出现肿胀,伴有向右侧上肢放射的钝痛和隐痛,肌力评估为IV/V级。包括计算机断层扫描(CT)和磁共振成像在内的影像学检查显示,C4椎体右侧椎板有一个分叶状病变延伸至C5,导致脊髓和神经根受压。患者接受了C4 - C5椎板切除术及肿瘤完整切除。组织病理学检查确诊为内生软骨瘤。

随访与结果

6个月时,患者疼痛完全缓解,神经症状显著改善。3年和10年的随访CT扫描均未显示复发,患者在整个随访期间均无症状。

结论

本病例突出了颈椎内生软骨瘤手术切除后的长期成功结果,表明积极的手术干预可带来持续的无症状结局。10年的随访为颈椎内生软骨瘤的长期预后提供了有价值的见解,强调了早期完整手术切除及长期监测的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4e65/11632474/ca19a1c95387/JOCR-14-22-g001.jpg

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