脊髓畸胎瘤导致复发性无菌性脑膜炎(附1例报告及文献复习)

Recurrent Aseptic Meningitis Associated with Spinal Teratoma:One Case Report and Literature

目的报告1例脊髓畸胎瘤导致复发性无菌性脑膜炎患者的临床和影像学资料,探讨其可能机制。方法回顾性分析1例因练习瑜伽体位引发的复发性无菌性脑膜炎患者的临床资料、影像学及病理检查结果,并结合文献复习进行讨论。结果患者为32岁女性,临床诊断为复发性脑膜炎(7年)。脑膜炎每次发作前都有腰痛症状,而腰痛发生于瑜伽运动后,体检无脊髓受损体征。行腰椎MRI检查发现腰2-3节段髓内肿块,行肿块切除术,病理检查提示为成熟型畸胎瘤。术后类似复发性无菌性脑膜炎发作停止,随访12个月未再复发。结论脊髓畸胎瘤是复发性无菌性脑膜炎的罕见病因;临床因患者脊髓症状较轻易考虑为Mollaret脑膜炎;建议对无菌性脑膜炎无法确定病因患者行脊椎MRI检查协助诊断。

Aim A case of recurrent aseptic meningitis associated with spinal teratoma triggered by yoga practice was reported to explore the possible mechanism.Methods The clinical manifestation,neuroimaging and pathologic findings of the patient were retrospectively analyzed.The related literature was reviewed and discussed.Results A 32-year-old female suffered from recurrent meningitis for 7 years with no signs of spinal cord injury.Each episode was preceded by lower back pain which was triggered by activities such as yoga.Spinal MRI was never performed until the recent episode.It revealed an intramedullary mass at L2-3 levels and complete mass resection operation was performed.Pathology suggested mature spinal teratoma.After surgery,the attacks stopped and no recurrence was found in a follow-up of 12 months.Conclusion Spinal teratoma is a rare cause of recurrent aseptic meningitis.Due to the mild spinal symptoms,it is easy to be taken for Mollaret meningitis.Spinal MRI is recommended in patients with aseptic meningitis when the etiology cannot be identified.