Kataoka A, Shimizu K, Matsumoto T, Shintaku N, Okuno T, Takahashi Y, Akaishi K
Department of Pediatrics, Tenri Hospital, Japan.
Pediatr Hematol Oncol. 1995 Mar-Apr;12(2):179-84. doi: 10.3109/08880019509029552.
We treated an 11-year-old girl with spinal cord compression near an epidural tumor. Bone marrow examination confirmed the diagnosis of acute lymphoblastic leukemia (ALL). To reduce the compression we treated her immediately with high-dose dexamethasone and vincristine administered intravenously along with local irradiation. Three days later, radiation was discontinued because magnetic resonance imaging showed that the spinal cord compression was reduced. Complete remission has continued without evidence of neurologic sequelae for more than 3 years since diagnosis. Rapid reduction of the blasts resulted in tumor lysis syndrome, which was treated with conventional management and additional diuresis without hemodialysis. Epidural spinal cord compression in childhood ALL can be treated effectively with systemic chemotherapy and local radiotherapy without laminectomy.
我们治疗了一名11岁患有硬膜外肿瘤附近脊髓压迫的女孩。骨髓检查确诊为急性淋巴细胞白血病（ALL）。为减轻压迫，我们立即用大剂量地塞米松和静脉注射长春新碱对她进行治疗，并同时进行局部放疗。三天后，由于磁共振成像显示脊髓压迫减轻，放疗停止。自诊断以来，完全缓解持续了3年多，没有神经后遗症的迹象。原始细胞的快速减少导致肿瘤溶解综合征，采用传统治疗方法并增加利尿治疗，未进行血液透析。儿童ALL的硬膜外脊髓压迫可以通过全身化疗和局部放疗有效治疗，无需进行椎板切除术。
