Sato M, Kondo A, Otsuka S, Tanabe H, Matsuura N, Hasegawa K, Chin M, Saiki M
Department of Neurosurgery, Kitano Medical Research Institute and Hospital, Osaka, Japan.
No Shinkei Geka. 1993 Dec;21(12):1143-7.
The authors report a rare case of a large cystic cervical neurinoma. A 45-year-old female was admitted to our clinic because of motor weakness of the right upper extremity, numbness of the right fingers and right posterior cervical pain. Metrizamide CT myelography demonstrated the outline of a low density mass. MRI showed a mass revealing low signal intensity on T1-weighted image, high signal intensity on T2-weighted image and marginal enhancement on contrast image with Gd-DTPA. The mass which was diagnosed as cystic tumor, was located in the intradural extramedullary space between C4 to C5 segments. After C4 through C5 laminectomy, the tumor was found to originate from the C5 anterior motor root. The tumor consisted mostly of a cystic part with a very thin solid compartment beneath the capsule. Postoperative course of the patient was uneventful. Although spinal neurinoma is one of the most common spinal tumors, an almost completely degenerated large cystic spinal neurinoma is extremely rare. MRI with Gd-DTPA was useful for the diagnosis of the cystic neurinoma by clearly enhancing the margin of the tumor.
作者报告了一例罕见的巨大囊性颈神经鞘瘤病例。一名45岁女性因右上肢运动无力、右手手指麻木及右颈后部疼痛入住我院。甲泛葡胺CT脊髓造影显示低密度肿块轮廓。MRI显示肿块在T1加权像上呈低信号强度,在T2加权像上呈高信号强度,注射钆喷酸葡胺(Gd-DTPA)增强扫描后边缘强化。该肿块被诊断为囊性肿瘤,位于C4至C5节段的硬脊膜外髓外间隙。行C4至C5椎板切除术后,发现肿瘤起源于C5前运动神经根。肿瘤主要由一个囊性部分组成,囊壁下方有一个非常薄的实性部分。患者术后恢复顺利。虽然脊髓神经鞘瘤是最常见的脊髓肿瘤之一,但几乎完全退变的巨大囊性脊髓神经鞘瘤极为罕见。注射Gd-DTPA的MRI通过清晰强化肿瘤边缘,对囊性神经鞘瘤的诊断很有帮助。