Inagaki Ryo, Kohno Daisuke, Shigekawa Seiji, Inoue Akihiro, Kitazawa Riko, Kunieda Takeharu
Department of Neurosurgery, Ehime University School of Medicine, Toon, Ehime, Japan.
Division of Diagnostic Pathology, Ehime University School of Medicine, Toon, Ehime, Japan.
Surg Neurol Int. 2025 Jan 31;16:28. doi: 10.25259/SNI_993_2024. eCollection 2025.
Granular cell tumors (GCTs) are rare, usually benign, tumors with classic histomorphology. This tumor can occur throughout the body, but the spine is a distinctly rare location. Here, we report a very rare case of intramedullary GCT arising in the thoracic spinal cord.
A 36-year-old woman presented to our hospital with an approximately 1-year history of gradually worsening numbness in the left toe and weakness in both lower limbs. Neuroimaging showed a tumor mass in the upper spine at the level of thoracic vertebrae 7-8, appearing hypointense on T2-weighted imaging (WI) and showing uniform gadolinium enhancement on T1-WI. Complete surgical resection was successfully performed. Histopathological examination revealed round or polygonal cells with abundant granular eosinophilic cytoplasm strongly staining for S-100 and SOX10, and benign intramedullary GCT in the thoracic spinal cord was diagnosed. Postoperative magnetic resonance imaging (MRI) showed no residual tumor, and the patient recovered well from this intervention, showing no sequelae. Follow-up neuroimaging after 2 years showed no signs of recurrence.
This report describes an extremely rare case of GCT arising from the intramedullary thoracic spinal cord, which is difficult to diagnose by routine neuroimaging. Therefore, accurate diagnosis requires careful identification of clinical signs, MRI including hypointensity on T2-WI, and analysis of combined morphologic and immunohistochemical studies.
颗粒细胞瘤（GCTs）是一种罕见的、通常为良性的肿瘤，具有典型的组织形态学特征。这种肿瘤可发生于全身各处，但脊柱是一个明显罕见的发病部位。在此，我们报告一例发生于胸段脊髓的髓内颗粒细胞瘤，极为罕见。
一名36岁女性因左足趾逐渐加重的麻木及双下肢无力约1年病史就诊于我院。神经影像学检查显示在胸7-8椎体水平的上脊柱有一肿瘤肿块，在T2加权成像（WI）上呈低信号，在T1加权成像上呈均匀钆强化。成功实施了完整的手术切除。组织病理学检查显示圆形或多边形细胞，具有丰富的嗜酸性颗粒状细胞质，S-100和SOX10染色强阳性，诊断为胸段脊髓良性髓内颗粒细胞瘤。术后磁共振成像（MRI）显示无残留肿瘤，患者经此干预恢复良好，无后遗症。2年后的随访神经影像学检查未显示复发迹象。
本报告描述了一例极为罕见的起源于胸段脊髓髓内的颗粒细胞瘤病例，常规神经影像学检查难以诊断。因此，准确诊断需要仔细识别临床体征、包括T2加权成像上低信号的MRI以及综合形态学和免疫组织化学研究分析。
