Cho D Y, Wang Y C, Chen J T
Department of Surgery, Taichung Veterans General Hospital, Taiwan, Republic of China.
Spine (Phila Pa 1976). 1995 Nov 1;20(21):2341-4. doi: 10.1097/00007632-199511000-00014.
This is a report of a man with carcinoma of the anus and intradural metastasis to the cauda equina.
To perform a laminectomy with tumor removal for relief of pain.
Only 25 cases of intradural spinal metastasis have been reported in the English literature. This is the first report of a metastatic case, moving from the carcinoma of the anus to the cauda equina.
Magnetic resonance imaging showed an ill-defined mass, with central necrosis, to the cauda equina. The possibility of intradural metastasis to the cauda equina was indicated by unique pain symptoms.
The patient's back pain subsided after total laminectomy of L3-L5 with subtotal removal of the tumor. The residual tumor became smaller with postoperative radiation.
Magnetic resonance imaging is a good diagnostic choice in this situation. The cause of the metastasis was unclear, but it was presumed to have occurred through the perineural lymphatic ducts. Laminectomy with tumor removal is feasible for relieving pain and demonstrating pathology.
本文报告一例肛管癌伴马尾神经硬膜内转移的病例。
行椎板切除术并切除肿瘤以缓解疼痛。
英文文献中仅报道过25例硬膜内脊髓转移病例。这是首例从肛管癌转移至马尾神经的病例报告。
磁共振成像显示马尾神经有一界限不清的肿块，伴有中央坏死。独特的疼痛症状提示存在马尾神经硬膜内转移的可能性。
患者在L3 - L5全椎板切除并次全切除肿瘤后背痛缓解。术后放疗使残留肿瘤缩小。
在这种情况下，磁共振成像是一种很好的诊断选择。转移原因尚不清楚，但推测是通过神经周围淋巴管发生的。椎板切除术并切除肿瘤对于缓解疼痛和明确病理是可行的。
